Assistência de enfermagem na atenção psicossocial: revisão narrativa de literatura / Nursing assistance in psychosocial care: narrative review of literature / Asistencia de enfermería en atención psicosocial: revisión narrativa de la literatura

Introdução: O movimento da Reforma Psiquiátrica, que teve início em meados da década de 1970 e continua até os dias atuais, fez uma grande mudança na estrutura do modelo de atenção à saúde mental brasileiro, propondo integrar e fundamentar estratégias que facilitem a reinserção social e familiar dos utentes.A discussão sobre o cuidado domiciliar e em saúde mental vem dos autores que levantam a hipótese de que o cuidado é necessário dentro do lar porque faz a diferença, tem um efeito positivo na reabilitação psicossocial de pessoas com transtornos mentais ou sofrimento mental. Objetivo: Analisar as publicações sobre assistência de enfermagem na atenção psicossocial. Resultados e Discussão: Trata-se de um estudo bibliográfico do tipo revisão narrativa de literatura, método de pesquisa que permite incorporar evidências à prática clínica para coletar e sintetizar achados de pesquisa sobre determinado tema ou questão de forma sistemática e ordenada. Conclusão: O tema da saúde mental está sendo periodicamente visto e estudado, de diversas vertentes, alguns focam no ambiente que o usuário de álcool/drogas é cuidado, já outros na situação na qual ele se encontra, isso é de suma importância para que o usuário de álcool/drogas possa ser cuidado em um ambiente seguro, com bons profissionais, e que possa retornar a conviver em sociedade. PALAVRAS-CHAVE: Saúde Mental; Transtornos Relacionados ao Uso de Álcool; Enfermagem Psiquiátrica.

Introduction: The Psychiatric Reform movement, which began in the mid- 1970s and continues to the present day, has made a major change in the structure of the Brazilian mental health care model, proposing to integrate and substantiate strategies that facilitate the social and family reintegration of users.The discussion about home care and mental health comes from the authors who raise the hypothesis that care is necessary within the home because it makes a difference, has a positive effect on the psychosocial rehabilitation of people with mental disorders or mental suffering. Objective: To analyze publications on nursing care in psychosocial care. Results and Discussion: This is a bibliographic study of the type of narrative literature review, a research method that allows to incorporate evidence into clinical practice to collect and synthesize research findings on a given theme or question in a systematic and orderly manner. Conclusion: The theme of mental health is being periodically seen and studied, from various perspectives, some focus on the environment that the user of alcohol/drugs is cared for, while others in the situation in which he finds himself, this is of paramount importance so that the user of alcohol/drugs can be cared for in a safe environment, with good professionals, and that can return to live in society.

Introducción: El movimiento de la Reforma Psiquiátrica, que comenzó a mediados de la década de 1970 y continúa hasta el día de hoy, ha hecho un cambio importante en la estructura del modelo de atención de salud mental brasileño, proponiendo integrar y basar estrategias que faciliten la reintegración social y familiar de los usuarios. La discusión sobre la atención de salud mental y en el hogar viene de los autores que plantean la hipótesis de que la atención es la diferencia necesaria dentro del hogar porque hace una , tiene un efecto positivo en la rehabilitación psicosocial de las personas con trastornos mentales o sufrimientos mentales. Objetivo: analizar las publicaciones sobre la atención de enfermería en atención psicosocial. Resultados y Discusión: Se trata de un estudio bibliográfico del tipo de revisión narrativa de la literatura, un método de investigación que permite incorporar evidencia en la práctica clínica para recolectar y sintetizar los hallazgos de investigación sobre un tema o pregunta dada de manera sistemática y ordenada. Conclusión: El tema de la salud mental se está viendo y estudiando periódicamente, de diversas maneras, algunos se centran en el ambiente que se está cuidando al usuario de alcohol/drogas, mientras que otros en la situación en que se encuentra, esto es de gran importancia para el usuario de alcohol/drogas para ser capaz de ser cuidadoso en un ambiente seguro, con buenos profesionales, y que puede volver a vivir juntos en la sociedad.

Alcohol Use Disorders and Diabetes Mellitus

Alcohol use disorder is a chronic relapsing brain disorder and is associated with high mortality and morbidity. Chronic alcohol use worsens diabetes and associated diabetes-related complication. Alcohol use, especially over the long-term, can impact the glycemic control in persons with diabetes mellitus. Heavy consumption of alcohol in people with diabetes can lead to worsening of diabetes-related complications like diabetic ketoacidosis, altered lipid metabolism, peripheral neuropathy, sexual dysfunction and cardiovascular disease. This review aims to describe the association between alcohol use and glucose tolerance, effects of alcohol on the pre-existing diabetes; association between alcohol use, diabetes mellitus and diabetes-related complications and interaction of medicines used to treat diabetes with alcohol.

Métodos cognitivos e comportamentais para quando o paciente não está disponível para parar de beber / Cognitive and behavioral methods when the patient is not available to stop drinking

As orientações para a prática clínica dos Transtornos Relacionados ao Álcool (TRA) preconizam que a avaliação dos pacientes deve ser efetuada desde logo sob os princípios da abordagem motivacional e que devem ser disponibilizadas intervenções psicológicas baseadas na terapia cognitivo-comportamental para prevenção da recaída ou treinamento do beber "moderado" (quando apropriado), que possam ser combinadas com fármacos. Considerando que existem poucas evidências sobre o que fazer quando os pacientes não estão preparados para parar totalmente de beber ou no período que antecede o início de um programa de desintoxicação medicamente assistida, esta revisão incidiu sobre os vários métodos comportamentais e cognitivos que podem ser aplicadas nos casos em que a cessação total do consumo do álcool não se coloca como objetivo terapêutico imediato. As seguintes abordagens foram apresentadas: método BRENDA, Intervenção Comportamental para Preparação da Abstinência, Método Comportamental de Extinção de Sinclair, Experiência de um Mês de Abstinência e as Técnicas de Moderação/Controle. Foram discutidos e caracterizados vários métodos comportamentais que permitem repensar radicalmente os tratamentos tradicionais para os TRA.(AU)

Guidelines for the clinical practice of alcohol use disorders (AUD) suggest that patient assessment should be carried out immediately under the principles of the motivational approach and that psychological interventions based on cognitive behavioral therapy should be available to prevent relapse or "moderate" (when appropriate) drinking, which can be combined with medication. Given that there is little evidence on what to do when patients are not fully prepared to stop drinking or in the period preceding the start of a medically assisted detoxification program, this review focused on the various behavioral and cognitive methods that may be applied in cases where the total cessation of alcohol consumption is not an immediate therapeutic goal. The following approaches were presented: the BRENDA method, Behavioral Intervention for Abstinence Preparation, Sinclair's Behavioral Extinction Method, One Month Abstinence Experienceand the Moderation/Control Techniques. Several behavioral methods have been discussed and characterized allowing a radical rethinking of traditional treatments for AUD.(AU)

Las orientaciones para la práctica clínica de las perturbaciones del uso del alcohol (PUA) preconizan que la evaluación de los pacientes debe ser efectuada desde el principio bajo los principios del abordaje motivacional y que deben ser disponibles intervenciones psicológicas basadas en la terapia cognitivo-conductual para prevenir la recaída o entrenar el beber "moderado" (cuando sea apropiado), las cuales pueden ser combinadas con fármacos. Teniendo en cuenta que hay pocas evidencias sobre qué hacer cuando los pacientes no están preparados para parar totalmente de beber o en el período anterior al inicio de un programa de desintoxicación médicamente asistida, esta revisión se centró en los diversos métodos conductuales y cognitivos que pueden ser se aplican en los casos en que el cese total del consumo de alcohol no se plantea como objetivo terapéutico inmediato. Se presentaron los siguientes enfoques: método BRENDA, intervención conductual para la preparación de la abstinencia, método de extinción conductual Sinclair, Experiencia de un mes de abstinenciay técnicas de moderación/control. Se discutieron y caracterizaron varios métodos comportamentales que permiten repensar radicalmente los tratamientos tradicionales para las PUA.(AU)

Epidemiology of Alcohol Use Disorders and Alcohol Policy / 신경정신의학

Alcohol is a substance that has a negative impact on public health according to the various drinking patterns and amount consumed. Alcohol epidemiology covers an investigation of the prevalence of alcohol use disorders, high risk drinking behaviors, and level of consumption per capita. The epidemiologic data of alcohol is an important guide to develop evidence-based alcohol policies. The high rate of drinking among middle aged males and young females is the result of recent socio-economic changes in South Korea and aggressive marketing from the alcohol industry. The high rate of treatment among middle-aged men indicates that the treatment of alcoholism begins later. Regarding alcohol policy, restrictions on alcohol accessibility and advertisement, and brief intervention systems might help reduce alcohol problems. In addition, a continuum of care system needs to be established to provide timely appropriate treatment and rehabilitation services.

Research progress of the therapy in comorbidity of bipolar disorder and alcohol use disorder / 中华行为医学与脑科学杂志

Mood disorders and substance use disorders often co-occur, but few evidence-based data have been conducted to guide the management of comorbidity bipolar disorder with alcohol use disorder.Therefore, it's lack of clinical researches and expert consensus.This review inducted the research progress of the comorbidities of bipolar disorder and alcohol use disorder in recent years, and finds that drug treatment or combined treatment with other treatment methods has certain curative effect suggesting that the comprehensive treatment of drug or combined non-drug treatment for comorbidities is the future direction.

Analysis of Drinking Behavior According to Household Type: Using Data from the 6th Korean National Health and Nutrition Examination Survey

BACKGROUND: Previous studies have revealed an association between health behavior and household type; moreover, there have been debates on the relation between drinking behavior and household type. Therefore, we examined drinking behavior of one-person households and compared the differences with multi-person households.METHODS: This study analyzed 8,966 participants, aged 19 years or older, in the 6th Korea National Health and Nutrition Examination Survey (2013, 2015). All participants were categorized into one- and multi-person households. The general characteristics were extracted using a chi-square test, and the risk of drinking behavior of one-person households was analyzed via multiple logistic regression.RESULTS: There were no statistically significant differences in the drinking behavior of men by household type. However, the risks of binge and problem drinking were 3.242 times (95% confidence interval [CI], 1.624–6.471) and 2.488 times (95% CI, 1.097–5.642) higher, respectively, in one-person household women than in multi-person household members aged between 19 and 39 years. Furthermore, the risk of problem drinking was 2.266 times (95% CI, 1.126–4.561) higher in one-person household women than in multi-person household members aged between 40 and 64 years.CONCLUSION: Considering the increasing trend of one-person households, follow-up studies on drinking behavior of one-person households are needed; the findings of these studies need to be used to prevent alcohol-related diseases and socio-economic problems.

Research progress of the therapy in comorbidity of bipolar disorder and alcohol use disorder / 中华行为医学与脑科学杂志

Mood disorders and substance use disorders often co-occur,but few evidence-based data have been conducted to guide the management of comorbidity bipolar disorder with alcohol use disorder. Therefore,it's lack of clinical researches and expert consensus. This review inducted the research progress of the comorbidities of bipolar disorder and alcohol use disorder in recent years,and finds that drug treatment or combined treatment with other treatment methods has certain curative effect suggesting that the comprehen-sive treatment of drug or combined non-drug treatment for comorbidities is the future direction.

A Study Of Clinical Profile Of Patients With New Onset Alcohol Related Seizures

Aim: To study the clinical profile of patients with new onset alcohol related seizures (ARS) Materials and Methods: This was a prospective, hospital based, observational study of 50 consecutive patients without a prior diagnosis of epilepsy presenting with seizures related to alcohol intake, to either emergency room or out–patient department, Department of General Medicine, SVS Medical College, Mahabubnagar, Telangana state, between October 2015 to September 2017. An informed and written consent was taken from the patient or immediate responsible attendant. Detailed history including the personal and family history was obtained from all patients. AUDIT scoring was done in all patients. Detailed examination findings were noted down. EEG and CT Scan Brain was done in all patients. MRI Brain was done when required. Results: A total of 50 patients with alcohol withdrawal seizures were included in the study of which 24(48%) were males and 26(32%) were females. Majority of the patients presented with seizures within 6 days following the last bout of alcohol (85%). All the 50(100%) patients presented with generalized tonic clonic seizures (GTCS) and 8(16%) progressed in to status epilepticus. Withdrawal symptoms were present in 24(48%) patients. Family history of seizures in the first degree relative was present in 4(8%) patients. CT evidence of cortical atrophy was present in 10 (20%) patients. EEG suggestive of seizures was present in 15 (30%) patients. Conclusion: There was a slight female preponderance of alcohol related seizures in this study. Majority presented within 6 days after the last bout of alcohol. All presented with GTCS. EEG and CT Scan Brain reports were normal in majority of the patients.

Association of High-Risk Drinking with Metabolic Syndrome and Its Components in Elderly Korean Men: The Korean National Health and Nutrition Examination Survey 2010–2012 / 가정의학회지

BACKGROUND: Previous studies have examined the association between alcohol consumption and metabolic syndrome (MetS) in adults, but studies in the elderly are lacking. We examined the relationship between high-risk alcohol consumption and MetS in elderly Korean men using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire from the 2010–2012 Korean National Health and Nutrition Examination Survey. METHODS: Among 25,534 subjects, 2,807 were men >60 years of age; after exclusions, we included 2,088 men in the final analysis. We categorized the study participants into three groups according to AUDIT score: low risk (0–7), intermediate risk (8–14), and high risk (≥15 points). RESULTS: Among the study population, 17.0% of the men were high-risk drinkers, who had the highest mean waist circumference, systolic and diastolic blood pressure (BP), fasting plasma glucose (FPG), and triglyceride (TG) levels. The overall prevalence of MetS was 41.9% in the elderly men, and it was significantly higher in the group with high (48.3%) versus low (31.9%) AUDIT scores. The prevalence of MetS components (elevated BP, high FPG, high TG, and low high-density lipoprotein cholesterol) was associated with a high AUDIT score. The odds ratios (95% confidence interval) of the high-risk group for MetS, elevated BP, and high TG were 1.40 (1.03–1.89), 1.82 (1.28–2.60), and 1.77 (1.30–2.41) after adjustment for confounding variables. CONCLUSION: AUDIT score was correlated with most MetS components in elderly Korean men.

Conhecimento e Abordagens acerca do Uso Problemático do Álcool / Knowledge and Approaches on the Issue of Alcohol Consumption / El Conocimiento y las Propuestas Presentadas acerca del Consumo Problemático de Alcohol

Resumo A ocorrência de mortes e adoecimentos relacionados ao consumo de bebidas alcoólicas é relevante em todo mundo e provoca custos altíssimos para a população. Trata-se de um estudo de intervenção, qualitativo e quantitativo, com objetivo de avaliar a efetividade de um curso de atualização para os profissionais que atuam na Atenção Primária à Saúde (APS) acerca do conhecimento e das formas de abordagens frente ao uso problemático do álcool em um município mineiro. O conteúdo do curso teve os constructos da Promoção de Saúde como referencial teórico. Aplicou-se um questionário com perguntas fechadas relativas ao conteúdo trabalhado, antes e após o curso. A amostra foi composta por 39 participantes trabalhadores da APS. Os resultados revelaram que, após o curso, o percentual total de acertos foi de 81,0%, evidenciando uma evolução de 11,4% do número de respostas corretas. Conclui-se que o modelo de intervenção composto por curso que aborda temas do cotidiano mais encontros com debates e espaço para a participação dos profissionais é uma proposta viável para atualização dos profissionais que atuam frente à problemática do consumo de bebidas alcoólicas. A proposta apresenta, ainda, uma possibilidade de atuação do profissional da Psicologia na rede municipal de saúde com foco nos constructos da Promoção de Saúde....(AU)

Abstract The occurrence of deaths and illnesses related to alcohol consumption is relevant throughout the world, causing exorbitant costs for the population. This is a qualitative and quantitative intervention study in order to analyze the effectiveness of a refresher course for professionals working with Primary Health Care (PHC) as regards knowledge and means of approach on the issue of alcohol consumption in a city of the State of Minas Gerais. The course followed the guidance of the constructs of Health Promotion as a theoretical framework. It was applied a questionnaire with closed questions regarding the content worked before and after the course. The sample consisted of 39 participants working with PHC. The results revealed that after the completion of the course the total percentage of correct answers was 81%, showing an increase of 11.4% in the number of correct answers. We conclude that the intervention model that consists of a course addressing everyday topics, plus meetings with debates and space for the participation of professionals, is a viable proposal to refresh professionals facing the issue of alcohol consumption. The proposal also presents a possibility for the Psychology professional to work in the municipal health network with a focus on the Health Promotion constructs....(AU)

Resumen La ocurrencia de muertes y enfermedades relacionadas con el consumo de bebidas alcohólicas es relevante en todo el mundo, causando altos costos a la población. Se trata de un estudio de intervención, cualitativo y cuantitativo, con el fin de evaluar la efectividad de un curso de actualización para los profesionales que actúan en la Atención Primaria a la Salud (APS) acerca del conocimiento y de las propuestas presentadas ante el consumo problemático del alcohol en un municipio de Minas Gerais. El contenido del curso ha seguido la orientación de las construcciones de Promoción de la Salud como un marco teórico. Se aplicó un cuestionario con preguntas cerradas relativas al contenido trabajado antes y después del curso. La muestra se compuso de 39 participantes trabajadores de la APS. Los resultados revelaron que una vez concluido el curso, el porcentaje total de respuestas correctas fue de 81,0%, con una evolución de 11,4% en el número de respuestas correctas. Llegamos a la conclusión de que el modelo de intervención que compone el curso plantea temas del cotidiano, además de los encuentros con los debates y el espacio para la participación de los profesionales, y es una propuesta viable para la actualización de los profesionales que actúan ante la problemática del consumo de bebidas alcohólicas. La propuesta también presenta la posibilidad de que el profesional de Psicología trabaje en la red municipal de salud enfocándose en los constructos de Promoción de la Salud....(AU)

The association of the polymorphism of the 5-HTT gene with alcohol use disorders / 中华行为医学与脑科学杂志

Objective To investigate the possible associations of two polymorphisms (5-HTTLPR and STin2VNTR)of the serotonin transporter gene with alcohol use disorders (AUD).Methods 281 AUD cases (AUDIT score≥ 10) and 277 healthy controls (AUDIT score ≤5) were recruited in this study.All participants were genotyped using the PCR technique.Results The frequency of the L-allele of the 5-HTTLPR was 39.01％,and the 10-allele of STin2VNTR was 8.42％ in this population,the allele frequencies of both polymorphisms were consistent with Asian normal populations.No significant association was observed between 5-HTTLPR and AUD,but the genotypic and allele frequencies of the STin2VNTR were significant different between two groups even after Bonferroni adjustment,the 12 repeat allele of the STin2VNTR was significantly associated with the risk effect for AUD.Haplotype analysis for those two polymorphisms revealed no association between 4 haplotype combinations and AUD.Conclusion There is no relationship between 5-HTTLPR and AUD.The STin2VNTR polymorphism of 5-HTT may play a role in the pathogenesis of AUD.

Reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test / 中华流行病学杂志

Objective To assess the reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test (AUDIT) among medical students in China and to provide correct way of application on the recommended scales.Methods An E-questionnaire was developed and sent to medical students in five different colleges.Students were all active volunteers to accept the testings.Cronbach's α and split-half reliability were calculated to evaluate the reliability of AUDIT while content,contract,discriminant and convergent validity were performed to measure the validity of the scales.Results The overall Cronbach's α of AUDIT was 0.782 and the split-half reliability was 0.711.Data showed that the domain Cronbach's α and split-half reliability were 0.796 and 0.794 for hazardous alcohol use,0.561 and 0.623 for dependence symptoms,and 0.647 and 0.640 for harmful alcohol use.Results also showed that the content validity index on the levels of items I-CVI)were from 0.83 to 1.00,the content validity index of scale level (S-CVI/UA) was 0.90,content validity index of average scale level (S-CVI/Ave) was 0.99 and the content validity ratios (CVR) were from 0.80 to 1.00.The simplified version of AUDIT supported a presupposed three-factor structure which could explain 61.175％ of the total variance revealed through exploratory factor analysis.AUDIT semed to have good convergent and discriminant validity,with the success rate of calibration experiment as 100％.Conclusion AUDIT showed good reliability and validity among medical students in China thus worth for promotion on its use.

Reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test / 中华流行病学杂志

Objective To assess the reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test (AUDIT) among medical students in China and to provide correct way of application on the recommended scales.Methods An E-questionnaire was developed and sent to medical students in five different colleges.Students were all active volunteers to accept the testings.Cronbach's α and split-half reliability were calculated to evaluate the reliability of AUDIT while content,contract,discriminant and convergent validity were performed to measure the validity of the scales.Results The overall Cronbach's α of AUDIT was 0.782 and the split-half reliability was 0.711.Data showed that the domain Cronbach's α and split-half reliability were 0.796 and 0.794 for hazardous alcohol use,0.561 and 0.623 for dependence symptoms,and 0.647 and 0.640 for harmful alcohol use.Results also showed that the content validity index on the levels of items I-CVI)were from 0.83 to 1.00,the content validity index of scale level (S-CVI/UA) was 0.90,content validity index of average scale level (S-CVI/Ave) was 0.99 and the content validity ratios (CVR) were from 0.80 to 1.00.The simplified version of AUDIT supported a presupposed three-factor structure which could explain 61.175％ of the total variance revealed through exploratory factor analysis.AUDIT semed to have good convergent and discriminant validity,with the success rate of calibration experiment as 100％.Conclusion AUDIT showed good reliability and validity among medical students in China thus worth for promotion on its use.

Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors / Sintomas de ansiedade social em alcoolistas em tratamento ambulatorial: prevalência, gravidade e preditores

ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD) and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 53 adults who were in treatment for alcohol dependence at a Brazilian public university outpatient service. Assessment instruments Social Phobia Inventory (SPIN), Short Alcohol Dependence Data and Beck Depression Inventory. Bivariate analyses between the categorical outcome (Probable SAD: SPIN ≥ 19) and explanatory variables were conducted. Correlates of SPIN total and subscales scores (dimensional outcomes) were also investigated. Results The diagnosis and treatment of alcohol dependence occurred, on average, 30 years after the onset of alcohol use and 39.6% of the 53 patients (37 men and 16 women) reported alleviation of social anxiety symptoms with alcohol use. Twenty-four (45.3%) patients presented probable SAD. These patients differed from non-SAD alcohol-dependent individuals by having lower income and higher frequency of depression, suicidal ideation, suicide plans and attempts. The SPIN subscales mostly associated with suicidal behaviors were social inadequacy and social inferiority. Conclusions SAD symptoms are common among help-seeking alcohol-dependent individuals and should be directly investigated and treated, since depression and suicidality are associated with this comorbidity. Prospective studies are needed to assess the impact of SAD treatment on the clinical course of alcohol dependence.

RESUMO Objetivos Altas taxas de comorbidade têm sido descritas entre o transtorno de ansiedade social (TAS) e os transtornos por uso de álcool, mas os preditores dessa comorbidade são pouco conhecidos, e a maioria dos estudos envolve pacientes com diagnóstico primário de TAS. Os objetivos foram estimar a prevalência e a gravidade de sintomas de TAS em pacientes dependentes de álcool e investigar fatores sociodemográficos e clínicos associados à comorbidade com TAS, incluindo risco de suicídio. Métodos Estudo transversal com 53 adultos em tratamento ambulatorial para dependência de álcool num hospital público universitário brasileiro. Instrumentos de avaliação: Social Phobia Inventory (SPIN), Short Alcohol Dependence Data e Beck Depression Inventory. Foram conduzidas análises bivariadas entre o desfecho categorial (provável TAS: SPIN ≥ 19) e as variáveis explanatórias. Correlatos dos escores total e das subescalas da SPIN (desfechos dimensionais) também foram investigados. Resultados O diagnóstico e o tratamento da dependência de álcool ocorreram em média 30 anos após o início do uso de álcool, e 39,6% dos 53 pacientes (37 homens e 16 mulheres) relataram alívio dos sintomas de ansiedade social com o uso de álcool. Vinte e quatro (45,3%) pacientes apresentaram provável TAS. Esses pacientes diferiram dos alcoolistas sem TAS, por terem menor renda, maior frequência de depressão, ideação suicida, planos e tentativas de suicídio. As subescalas da SPIN que mais se associaram com comportamentos suicidas foram inadequação social e inferioridade social. Conclusões Sintomas de TAS são comuns em alcoolistas em tratamento e devem ser diretamente investigados e tratados, já que depressão e suicidalidade associam-se com essa comorbidade. Estudos prospectivos são necessários para investigar o impacto do tratamento do TAS no curso clínico da dependência de álcool.

Alcohol use problems in migraine and tension-type headache / Consumo problematico de alcool na migranea e cefaleia do tipo tensional

Objective: The aim of this study was to assess alcohol use problems in patients with migraine and tension-type headache. Method: We evaluated 81 patients with migraine and 62 patients with tension-type headache. The identification of alcohol consumption problems was carried out with Alcohol Use Disorders Identification Test (AUDIT). Alcohol use problem was defined as an AUDIT score of 8 or above. The headache impact was calculated with headache impact test (HIT-6). Results: The proportions of alcohol use problem among patients with migraine and tension-type headache were 5.2% and 16.1%, respectively (P=0.044). The headache impact was significantly higher with migraine than with tension-type headache (P<0.0001). There was an inverse correlation between headache impact and AUDIT (P=0.043). Conclusions: Our results suggest that migraine patients are less prone to alcohol use problems than tension-type headache patients. One of the possible reasons is that migraine is associated with greater impact than tension-type headache. .

Objetivo: Este estudo avaliou o consumo problemático de álcool em pacientes com migrânea e em pacientes com cefaleia do tipo tensional. Método: Foram avaliados 81 pacientes com migrânea e 62 pacientes com cefaleia do tipo tensional. A avaliação do consumo de álcool foi realizada com o Teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT), sendo considerado consumo problemático quando o escore do AUDIT foi igual ou maior que 8. O impacto funcional da cefaleia foi avaliado pelo Teste de Impacto da Cefaleia (HIT-6). Resultados: As proporções de desordens relacionadas ao álcool entre pacientes com migrânea e cefaleia do tipo tensional foram 5,2% e 16,1%, respectivamente (P=0,044). O impacto funcional foi significativamente maior na migrânea que na cefaleia do tipo tensional (P<0,0001). Houve significativa correlação entre comprometimento funcional da cefaleia e os escores do AUDIT (P=0,043). Conclusões: Nossos resultados sugerem que pacientes com migrânea têm menor probabilidade de apresentar consumo problemático do álcool que pacientes com cefaleia do tipo tensional. Uma das possíveis explicações é que o impacto funcional da cefaleia é maior na migrânea que na cefaleia do tipo tensional. .

Relations between alcoholism and osteoporosis or femoral head necrosis / 中华流行病学杂志

Objective To explore the relationship of alcoholism between osteoporosis or femoral head necrosis.Methods In this case-control study,we selected 95 eligible patients with femoral head necrosis and another 67 cases of osteoporosis as case group,together with 342 patients of fractures from the Second Hospital affiliated to Shanxi Medical College,from February to December 2010,as the control group.Questionnaire was used to collect general information of the patients.Through comparative analysis,related factors of femoral head,osteoporosis were defined.18 patients with alcoholic femoral head necrosis,11 patients with alcoholic osteoporosis and 20 patients with fractures were selected from the above said three groups and going through the Alcohol Use Disorders Identification Test (AUDIT) as well as the Alcohol Use Disorders Scale (ADS).Using SPSS 13.0 conducted one-way ANOVA (analysis of variance),chi-square test,categorical logistic regression analysis were used for statistical analysis.Results Results from logistic regression analysis showed that the adjusted odds ratio of those subjects who liked drinking alcohol had an incidence of femoral head necrosis or osteoporosis as 7.70 (95％ CI:1.84,32.30) and 8.44 (95％ CI:1.70,41.90),respectively.The risks of using hormone for treating femoral head necrosis or osteoporosis were 78.43 (95％CI:11.20,149.05) and 22.75 (95％CI:2.59,100.27) times than those without.Data from the AUDIT showed that:over-dose of alcohol drinking habit existed 100％ in the femoral head necrosis group while 54.45％ in the osteoporosis group,while 75 percent patients in the fractures group had normal alcohol drinking habit.Statistically significant differences appeared in the three groups (P＜0.01).Results from the ADS showed that there were statistically significant differences between the ADS scores of the three groups (F=3.68,P=0.03).Conclusion Alcohol intake did seem to be highly correlated with the incidence rates of femoral head necrosis or osteoporosis.Alcohol-related necrosis could be viewed as alcohol-dependent diseases while alcohol-related and osteoporosis could partially be recognized as alcohol-dependent disease.

Association between Alcoholism Family History and Alcohol Screening Scores among Alcohol-dependent Patients

OBJECTIVE: Several tests can be used to screen for alcohol dependence (AD), a prevalent disease with a heterogeneous etiology. As some patients with AD have a strong familial tendency in this regard, a family history of alcohol use disorders can affect the outcomes of screening tests and diagnostic evaluations for AD. In this study, we evaluated associations between a family history of alcohol use disorders and evaluations using the Cut down, Annoyed, Guilty, Eye-opener (CAGE) test, Alcohol Use Disorder Identification Test (AUDIT), and Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV) diagnostic criteria among patients with AD. METHODS: We recruited 487 male patients with AD from eight hospitals in Korea. Patients were evaluated using the CAGE, AUDIT, and DSM-IV diagnostic criteria. Patients with and without family histories were compared in terms of these assessment tools. RESULTS: Drinking initiation, uncontrollable drinking, and problem drinking occurred earlier and CAGE "annoyed" scores were higher in patients with a family history. Alcohol problems before the age of 25 years, frequency of spontaneous or compulsive alcohol-seeking behavior, and frequencies of psychological dependence and guilt related to alcohol use were also higher. CONCLUSION: Earlier drinking problems, higher scores on specific items of the CAGE, and AUDIT, and meeting more diagnostic criteria indicate more dependent, harmful drinking by patients with AD who have a family history of this condition. Clinicians should consider patients' family history of alcohol use disorders when screening for AD to identify the correct diagnosis and develop appropriate treatment plans for these patients.

The Karamay community alcohol abuse and self-rated health status survey / 中华行为医学与脑科学杂志

ObjectiveTo investigate the health status and incidence of alcohol abuse of Xinjiang community residents.MethodsThrough multi-stage random sampling,1992 community residents ( 15-65years old) were assessed using socio-demographic information questionnaire,alcohol use disorders identification test (AUDIT) and self-rated health measurement scale-prior test(SHRMS).Single factor analysis and rank sum test were used to identify the incidence of alcohol abuse,the distribution of different populations,and the self-rated health status of abusers.ResultsTotally 298 cases of alcohol abuse were identified,and accordingly,the prevalence rate of alcohol abuse for general population was 15.1％ ( male 26.4％,female 4.8％ ).Key factors for alcohol abuse included male,middle-aged,well-educated,at work,administrative work,high income levels and large number of household.The differences among groups were statistical significant.Presumably the workplace population was at high risk of alcohol abuse.Alcohol abusers were significantly worse than general population in self-rated health status(P ＜ 0.01 ),especially in mental health and social health.ConclusionThe incidence of alcohol abuse is relatively high in Xinjiang rcgion,and the problem need more attention.Further survey and early intervention work for highrisk group are advised to achieve the purpose of prevention and control.

Alcohol Use Disorders Identification Test (AUDIT): an updated systematic review of psychometric properties

The Alcohol Use Disorders Identification Test (AUDIT) is an instrument used to screen for alcohol-related problems. It has been increasingly used in many different countries in both the original English-language version and its many translated versions. Because of the need for screening instruments of faster administration, shortened versions of the AUDIT have also been developed. This study was aimed at expanding the work by Berner and colleagues (2007) in an attempt to answer some remaining questions as well as to identify and evaluate studies on the validation of modified versions of the AUDIT, which have not been previously analyzed. In order to do so, we identified indexed articles published between 2002 and 2009 related to the psychometric qualities of the AUDIT by matching the keywords: alcohol, Alcohol Use Disorders Identification Test, and AUDIT. We found 47 articles that evaluated the AUDIT in different countries and in diverse health and community contexts, involving adolescent, adult, and elderly samples. The studies confirmed the validity and efficiency of the AUDIT in the identification of harmful use, abuse, and dependence of alcohol, both in the original version and in modified ones. The possibility of using brief and efficient versions is of great value, since certain health contexts demand faster assessment. The results also showed that the reduced versions have satisfactory psychometric qualities, sometimes with sensitivity values higher than those of the AUDIT itself. The studies analyzed confirm the efficiency of the AUDIT both in its original, reduced, and language-adapted versions in different contexts and cultures.

Performance of the AUDIT Alcohol Consumption Questions (AUDIT-C) and AUDIT-K Question 3 Alone in Screening for Problem Drinking / 가정의학회지

BACKGROUND: In the busy primary care setting, there are several limitations in applying Alcohol Use Disorders Identification Test in Korea (AUDIT-K) to screen problem drinking. Thus, for primary healthcare practice, we evaluated AUDIT-C, which covers questions from 1 to 3 in AUDIT-K, and AUDIT-K Question 3 Alone to present cut points for these two screening questionnaire according to AUDIT-K test scores. METHODS: In a university hospital, we surveyed 302 males with a drinking history via self-administered questionnaire including AUDIT-K, from November 2007 to April 2008. On the basis of total score in AUDIT-K, we divided them into four groups: normal, problem drinking, alcohol use disorder, and alcohol dependence. For each alcohol drinking behavior pattern, we drew the receiver operating characteristics (ROC) curves to present cut points for appropriate sensitivity and specificity. In addition, we compared the performance of AUDIT-C and AUDIT-K Question 3 Alone through area under the curve (AUC). RESULTS: For AUDIT-C, we designated the score 8 or more as problem drinking, 9 or more as alcohol use disorder, and 11 or more as dependence. The results of sensitivity/specificity for each group were 82%/76%, 76%/79%, 80%/86%, respectively, which were suitable for screening. For AUDIT-K Question 3 Alone, we defined the score 3 or more as problem drinking or alcohol use disorder and the score 4 as dependence. The results of sensitivity/specificity for each group were 79%/80%, 84%/67%, 85%/77%, which were appropriate for screening. For every drinking behavior group, AUDIT-C was superior to AUDIT-K Question 3 Alone in screening performance (problem drinking: 0.88 vs. respectively 0.85, alcohol use disorder: 0.86 vs. 0.82, alcohol dependence: 0.88 vs. 0.81) CONCLUSION: We confirmed that both AUDIT-C and AUDIT-K Question 3 Alone, which are more convenient and have fewer time con-straints than AUDIT-K, are reasonable screening methods for problem drinking. Thus, we recommend further drinking assessment and proper intervention for male drinkers who have scores 8 or more in AUDIT-C or 3 or more in AUDIT-K Question 3 Alone.