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Background: Daily alcohol consumption above recommended limits is an important cause of Alcoholic Lher Disease. Hence, this study aimed to assess the knowledge of Alcoholic Liver Disease among alcohol consumers and screenfor alcohol misuse, dependence, and disorder. Methods: A community-based cross-sectional survey using simple random sampling technique was conducted on residents ofÅfikpo age 15 and above who consume alcohol using a structured questionnaire to obtain information on alcoholic use disorder and alcohol dependence. The sample size Itas determined Il'ith the aid of a Raosoft sample size calculator. Data obtained was entered into an excel spreadsheetfor data cleaning. The frequency, percentages and mean and Standard deviation was also obtained. Data was exported into IBM SPSS to determine the relationship behre.en knou:ledge of Alcoholic Liver Disease and demographic variables using One-way ANOL4 and Chi-Square Il'here appropriate at P-value <0.05 and 5% significance level. Results: The total number of study participants was 435 with a response rate of 97%. Out of which had a good knowledge of Alcoholic Liver Disease. Adults above the age of 60 had a mean audit score of 12.808 Il'hile male respondents had a mean audit score of 11.395. Adolescents had a mean CAGE test score of 1.89 while adults above 60 scored 2.48. Houâ¢ever, participants with no education had the highest mean CAGE score of2.27. The males had good knowledge ofAlcoholic Liver Disease. (P 0.006). Conclusion: The residents ofÅfikpo community have a good knowledge ofAlcoholic Lher Disease though there is alcohol use disorder, alcohol misuse and dependence amongst residents in the community. Gender is the only demographic characteristics that influenced the knowledge ofAlcoholic Liver Disease
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Humans , Alcohol Amnestic Disorder , Liver Diseases, Alcoholic , Therapeutics , Alcoholism , Diet, HealthyABSTRACT
ObjectiveTo analyze the association between alcohol dependence and overweight and obesity among high school students. MethodsThis study adopted stratified cluster sampling method. Four high schools （one vocational high school included） were selected as the research sites. We used self-designed questionnaires to investigate the drinking behavior of high school students. This study used propensity score matching method to control confounding factors （e.g gender， school type， etc.）. Then we compared the differences in drinking behavior between obese/overweight group and normal weight group after matching， and used a multivariate logistic regression model to analyze the relationship between drinking behavior and overweight and obesity. ResultsA total of 811 high school students participated in the survey. 60 people were excluded due to mild and moderate weight loss， and 751 people were normal or obese/overweight. After 1：1 propensity score matching， there were 217 people each in obese/overweight group and normal group. The characteristics of gender， school type， grade and family economic level of the two groups were balanced after matching. The difference was statistically significant （P<0.05） between obese/overweight and normal group in the following： drinking of alcohol at high school， alcohol dependence， the maximum drinks at one time， drinking of alcohol at family gatherings， whether bought alcohol for others， whether their family members recommended drinking， whether they have tried to quit drinking in the past year， and the time of blush after drinking. The multivariate logistic regression analysis indicated that the degree of alcohol dependence （the alcohol use disorder score ≥ 8） was a risk factor for overweight and obesity （OR=3.600， 95%CI： 1.244‒10.424）. Besides， having bought alcohol for others and family members advising alcohol consumption were suggested to be protective factors for overweight and obesity （OR=0.525， 95%CI： 0.309‒0.890 and OR=0.377， 95%CI： 0.222‒0.641）. ConclusionHigh school students who have alcohol dependence suffer a higher risk of obesity/overweight， while high school students who may have drinking behaviors but do not have alcohol dependence have a lower risk of obesity/overweight. It is critical to guide young people on drinking in terms of health.
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@#Introduction: Alcohol, when used frequently, accelerates the ageing process, causes brain damage, and results in a reduced volume of grey and white matter, leading to frontal lobe abnormalities. The neurotoxicity resulting from alcohol overuse affects the higher functions of the brain. This study aimed to evaluate the effect of alcohol dependence on the executive functioning of the brain. Methods: This study was carried out as a case-control study among 60 patients with alcohol dependence and 60 controls. Assessment of executive function was carried out using the Comprehensive trail-making test (CTMT) and the Wisconsin card sorting test (WCST). Comparison between the alcohol dependence group and normal healthy controls were calculated using the Mann-Whitney U test as data followed a non-parametric distribution. Results: The mean age of the participants among the cases and controls was 38.3±5.5 years and 37.8±5.4 years, respectively. The results showed a significant difference in both WCST and CTMT between cases and controls (p<0.05). Conclusion: This study concludes that there was an impaired performance in executive functions in alcohol- dependence patients in early abstinence compared to normal controls showing frontal lobe impairment in alcohol-dependence patients.
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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.
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Background:Relapse to alcohol dependence after successful detoxification and rehabilitation is a public health concern worldwide. Although the burden of alcohol dependence is massive in the Indian subcontinent, very little is known about the causes of relapse among patients treated for alcohol abuse. Hence, this study was designed to evaluate the prevalence and factors associated with relapse in patients of alcohol dependence disorder.Methods:50 male patients diagnosed with alcohol dependence (according to ICD-10 criteria) who attended both in-patient and out-patient outpatient department (OPD)of a tertiary care hospital were included in our study. Severity of Alcohol Dependence Questionnaire(SADQ)for severity of alcohol dependence, Presumptive Stressful Life Events Scales (PSLES) and relapse precipitant inventory were used for correlation of factors responsible for relapse amongst these alcohol abusers after informed consent and acquiring socio-demographic details.Results:Out of 50 patients enrolled in the study as per the International Classification of Diseases 10threvisionDiagnostic Criteria for Research (ICD-10 DCR), a majority (92%) were Hindus, 60% belonging to the rural background. Family history of alcohol dependence was found to be present among 46% patients, and a majority had moderate to severe alcohol dependence. Craving for alcohol was found to be the most common cause of relapse amongst these, and 72% patients showed moderate to severe stress on the PSLES scale.Conclusions:Alcohol consumption is emerging as a major public health problem in India. Regular follow up with family, peer and social support are essential along with vocational rehabilitation to prevent relapse. Multi-centric scientific community-based research studies have to be conducted in various individual states to understand the problem better. There is a dire need for various policymakers, media, professionals and society to come together and create awareness about the consequences of chronic alcohol through sensitization programmes and health education campaigns.
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Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavioral therapies (CBT) on the cognitive function and alcohol craving in patients with alcohol dependence.Methods:From March 2019 to September 2021, a total of 150 patients with alcohol dependence were enrolled and randomly divided into rTMS treatment group (rTMS+ sham CBT, n=41), CBT treatment group (CBT+ sham rTMS, n=34), rTMS+ CBT treatment group( n=36) and control group (sham rTMS+ sham CBT, n=39). At baseline (before treatment), 2nd week, 8th week, 12th week and 24th week, alcohol dependence scale (ADS) was used to evaluate the degree of alcohol dependence, the obsessive compulsive drinking scale (OCDS) was used to assess patients' drinking craving, and Montreal cognitive assessment scale (MoCA) was used to assess the overall cognitive level of patients.SPSS 23.0 statistical software was used to compare the differences of ADS, OCDS and MoCA scale scores of the four groups by repeated measure ANOVA and simple effect analysis. Results:(1)The patients in the four groups were evaluated with ADS scale at baseline, 12th week and 24th week respectively.The interaction of group×time( F=1.279, P=0.279) and the main effect of group were not significant ( F=0.882, P=0.454), and the main effect of time was significant ( F=12.925, P<0.001) .Further simple effect analysis showed that the ADS score of rTMS+ CBT group was lower than that of baseline(14.48±5.70, 10.00±6.51) ( P=0.01) at 24th week.(2)Patients in the four groups were assessed with OCDs scale at baseline, 2nd week, 8th week, 12th week and 24th week, and the interaction of group×time was significant ( F=2.015, P=0.042). Further simple effect analysis showed that the OCDs scores of rTMS group and rTMS+ CBT group at each follow-up time node were lower than those at baseline period (all P<0.05). (3)Patients in the four groups were assessed with MoCA scale at baseline, 8th week, 12th week and 24th week, and the interaction of group×time was not significant ( F=1.660, P=0.106), and the main effect of group and the main effect of time were significant ( F=2.964, P=0.038; F=14.239, P<0.001). Further simple effect analysis showed that the score of MoCA scale in CBT group at the 24th week was higher than that at baseline (21.73±5.81, 24.60±3.98)( P=0.029), the score of MoCA scale in rTMS+ CBT group at the 24th week was higher than that at the 8th week (23.50±6.01, 25.95±2.87) ( P=0.006), and the score of MoCA scale in rTMS group at the 12th week was higher than that in control group (22.08±6.64, 26.64±2.46)( P=0.009). Conclusion:rTMS combined with CBT can be effective in improving alcohol craving and cognitive function in patients with alcohol dependence, and has a good long-term effect.
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Abstract Introduction Changes in brain-derived neurotrophic factor (BDNF) have been linked to the neuroadaptative consequences of chronic alcohol use and associated with disease severity and prognosis. Few studies have evaluated the influence of drug withdrawal and clinical and sociodemographic data on BDNF levels in severe alcohol users. Objectives Our goals were (1) to evaluate variation in BDNF levels during alcohol withdrawal and, (2) to assess the influence of putative confounding factors on BDNF levels. Methods Our sample consists of 62 men with alcohol use disorder undergoing a detoxification process. Serum BDNF levels were measured using a commercial sandwich-ELISA kit, at two points: before and after the detoxification period. Results We found an increase in BDNF levels during alcohol withdrawal (25.4±9.6 at admission vs. 29.8±10.2 ng/ml at discharge; p < 0.001), even after controlling for potential confounders (positive family history, number of days between blood sample collections, and age) (Generalized Estimating Equation: coefficient = -4.37, 95% confidence interval [95%CI] -6.3; -2.4; p < 0.001). Moreover, individuals who had first-degree relative with alcohol dependence had smaller increases in BDNF levels than individuals with no family history (14.8 [95%CI -5.3; 35.6] vs. 35.3 [95%CI 15.4; 74.8]; p = 0.005). Conclusions In summary, variation in BDNF levels seems to be influenced by withdrawal in severe alcohol users. A positive family history of alcohol dependence could also be a factor that influences variation in this biomarker.
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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.
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Background: Children of Alcoholics (COAs) form a large but heterogeneous group. Along with genetic predisposition to develop dependence, COAs may inherit other comorbid mental disorders, that the alcohol dependence syndrome often presents with. Prevalence of psychiatric morbidity in children in general have been reported to be around 6.46 % in Indian studies. Studies done with COAs have shown mixed findings, reporting both internalizing, externalizing and other behaviour problems. With dearth of Indian studies assessing psychiatric morbidity in COAs, a study was conducted to assess same. Methodology: A cross sectional study was conducted in private de-addiction centre in South India. Sixty- five children in age group of 6 to 18 years, whose fathers were admitted for alcohol dependence syndrome, were assessed along with their primary care giver using a semi-structured socio-demographic proforma and Kiddie-Schedule for Affective Disorder and Schizophrenia-Present and Lifetime version. Chi square and independent samples t test were used as appropriate. Results: 55.4% of the children had some lifetime psychiatric diagnosis. Around 21.5% of children had more than one lifetime diagnoses. Most common disorders found were anxiety disorders followed by mood disorders. Comparison of socio-demographic variables with respect to presence or absence of any lifetime psychiatric diagnosis, anxiety disorders, mood disorders and multiple diagnoses did not reveal any significant differences. Conclusion: Psychiatric morbidity in COAs was higher than in children in general population as reported in other studies. Having alcohol dependent males in de-addiction centres provides an avenue for early detection and treatment of psychiatric morbidity in their children.
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ABSTRACT Background: Exocytosis-related gene variants have been suggested to be associated with externalizing behaviors. Objective: This study aimed to examine VAMP2 26 bp Ins/Del, synaptotagmin XI (Syt11) rs3820594 and 33-bp promoter, Syntaxin 1A (Syn-1A) rs1569061 and SNAP-25 rs1051312 and rs3746544 polymorphisms, their serum levels and their relationship with impulsivity, temperament in individuals with alcohol dependence (AD) and healthy controls (HC). Methods: The study included 107 individuals with AD and 104 HCs. Single-nucleotide polymorphisms (SNPs) were studied with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and serum levels with ELISA. Michigan Alcohol Screening Test (MAST), Barratt Impulsiveness Scale-11 (BIS-11) and Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) were applied. Results: Syn-1A rs1569061 C allele polymorphism was significantly higher in AD group. Syn-1A rs1569061 C allele was associated with 1.5 times increased risk of AD. All serum levels were significantly higher in the HC group. There was a relationship between Syn-1A rs1569061 polymorphism and BIS-11 motor impulsiveness in the AD group; Syt11 rs3820594 polymorphism and BIS-11 total, TEMPS-A depressive, hyperthymia in the HC group. Discussion: In our study, gene variants and serum levels of synaptic vesicle and presynaptic plasma membrane proteins were related to AD, impulsivity and temperament.
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Background: The aim of the research was to study the biochemical profile of the male patients diagnosed with alcohol dependence syndrome and its correlation with the severity of dependence. Methodology: A descriptive study comprising of 60 patients admitted in the psychiatry de-addiction clinic at HSK hospital from 1st July 2017 to 31st December 2017 was done after taking institutional ethical committee clearance. A semi-structured proforma was used to determine the socio-demographic details like education, occupation, socio-economic status etc. the severity of dependence was determined using Severity of Alcohol Dependence Questionnaire (SADQ) scale and basic biochemical tests were performed. Descriptive analysis using an appropriate statistical test was done. Results: The mean age at presentation was 37.9 years. Out of 60 patients, 21 (35%) had mild dependence, 24 (40%) had moderate dependence and 15 (25%) had severe dependence. Hepatic enzymes AST and ALT were raised in 76.67% and 66.67% patients respectively. AST to ALT ratio was above 2 in 11.67% patients. There was a significant correlation between total SADQ scores and Alanine Transaminase (? = 0.281, P = 0.03, n = 60). Conclusion: The biochemical tests were deranged in most of the patients with alcohol dependence. Certain markers can be developed based on their significant association with the dependence levels, thus, helping in early diagnosis and prevention of alcohol dependence syndrome
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Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.
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Objective Using the information - motivation - behavior model (IMB) to intervene with the alcohol dependence patients and provide a new strategy for implementing health education. Methods Eighty-nine patients with alcohol dependence, who clinically recovered or improved after the discharge, were randomly divided into a research group and a control group. Both groups received routine health education, rehabilitation guidance and a follow-up call. The research group implemented additional IMB health education. The implementation effect on alcohol dependence scale (ADS), Michigan alcoholism screening test (MAST), and alcohol dependence prevention and treatment knowledge (self-designed questionnaire) of the two groups before and after intervention was analyzed. Results The relapse rate of the research group was lower than that the control group, which was statistically significant (P＜0.05). MAST scale and ADS scale in the research group were lower than those in the control group within 3 months and 6 months after the discharge, which was significant (P values of both scales ＜0.05). After the 6-month follow-up, the knowledge of alcohol dependence patients in the research group and their families was significantly higher than that in the control group (P＜0.05). Conclusion IMB health education implementation for alcohol dependence patients significantly reduced the relapse rate, decreased physical and psychological dependence, and improved the ability of patients to prevent and control alcohol dependence.
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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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India is considered to be the largest market for alcoholic products in the world with estimated 62.5 million alcohol users in 2005. There has been a rapid proliferation of bars and people are fast shedding the inhibitions over alcohol as a lifestyle choice. This study was conducted to determine the prevalence of alcohol dependence with relation to biopsychosocial factors as there is paucity in prevalence studies in India. MethodsThis is a cross sectional study, in which 500 people in 25 villages in 3 blocks out of 13 blocks in Coimbatore district were selected by multistage cluster sampling method. The study was conducted over a period of 3 months from November 2019 to January 2020. ResultsA total of 500 people was interviewed. Our study showed a prevalence of 44% of alcohol dependence and also has statistical significance with biopsychosocial factors. ConclusionsEnforcement of laws pertaining to drinking, focussing on supply reduction, legal limits for alcohol intake with age restriction and health promotion activities by community level awareness should be considered to lower the prevalence of alcohol dependence in future.
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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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Background: Alcohol is the commonest psychoactive substance used by Indians. Stress and self-esteem issues may cause alcohol use as a coping mechanism. The purpose of this study was to analyze the severity of alcohol dependence, gauge levels of perceived stress and self-esteem and study coping skills in patients. It further examined the relations between sociodemographic variables of patients, their perceived stress, self esteem and coping skills as well as duration and severity of alcohol dependence.Methods: Cross-sectional study of 200 patients with alcohol use disorder recruited by complete enumeration technique was undertaken. They were administered a semi-structured questionnaire along with Perceived Stress Scale (PSS-10), Rosenberg’s Self-Esteem Scale (RSES), Coping Inventory for Stressful situations (CISS-21) and Severity of Alcohol Dependence Questionnaire (SADQ). Associations and correlations were examined.Results: Almost half the patients had severe alcohol dependence. Less than one-fourth of the patients had low self esteem. There was a significant negative correlation between self esteem and severity of alcohol dependence as well as duration of alcohol use. Nearly half the patients had high perceived stress. There was a significant positive correlation between severity of alcohol dependence and perceived stress. Majority patients used task oriented coping skills. Patients of alcohol dependence having low self-esteem used predominantly avoidant-oriented coping skills.Conclusions: This study highlights the importance of thorough evaluation and screening in patients having alcohol dependence for self-esteem issues and perceived stress levels. Teaching effective coping skills, supportive psychotherapy and counselling can be effective. Multimodal treatment protocols will effectively lighten the stress caused by alcohol dependence.
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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.
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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.