Anxiety sensitivity, self-reported motives for alcohol and nicotine use, and level of consumption.

We examined the relationship between anxiety sensitivity, alcohol and nicotine use, and drinking and smoking motives in a nonclinical university population. Participants (n=293) completed the 16-item Anxiety Sensitivity (AS) Index and a drinking and smoking history questionnaire. Sixty percent of participants completed the Drinking Motives Questionnaire and 29% completed the Smoking Motives Questionnaire. Level of alcohol and cigarette consumption was not related to AS but was related to motives. AS was directly related to coping-related drinking and moderated the relationship between level of smoking and mood-related smoking motives. Although AS may be more predictive of coping-related drinking motives than of level of alcohol consumption, given the relationship between these types of drinking motives and abusive drinking, high AS individuals might be an at-risk group due to their reasons for drinking. In addition, striking differences were found between drinkers who smoke and those who do not smoke, suggesting that this subgroup may also represent an at-risk group of drinkers.

Alcohol and cannabis use in schizophrenia: effects of clozapine vs. risperidone.

BACKGROUND: Alcohol and cannabis use disorders worsen the course of schizophrenia. While the typical antipsychotics are of limited value in controlling substance use in schizophrenic patients, previous studies suggest that the novel antipsychotic clozapine (CLOZ) may decrease their substance use. We describe a retrospective study of the effects of the novel antipsychotics risperidone (RISP) and clozapine on alcohol and cannabis use in patients with schizophrenia or schizoaffective disorder and comorbid alcohol and/or cannabis use disorder. METHOD: This study involved retrospective assessment of abstinence (cessation of alcohol and cannabis use) in 41 patients treated with either risperidone (n=8) or clozapine (n=33) for at least 1 year. In 32 of these 41 patients, information was available on whether abstinence occurred during the 1-year period. RESULTS: Abstinence rates were significantly higher in patients treated with clozapine than in those treated with risperidone (54% vs. 13%, p=0.05). The nine patients treated for at least 1 year, but excluded from the analysis because time of cessation of use was not known, had all stopped alcohol/cannabis use during clozapine treatment. DISCUSSION: While the limitations of this retrospective study must be recognized, the data suggest that comorbid patients treated with clozapine are more likely to abstain from alcohol and cannabis use than are those treated with risperidone. Further prospective studies will be required to confirm these intriguing results.

Cognitive variables in alcohol dependent patients with elevated depressive symptoms: changes and predictive utility as a function of treatment modality.

The aim of the current study was to examine, through posthoc analyses, changes in and predictive utility of mood-related cognitive variables as a function of treatment modality in a group of alcohol dependent patients with elevated depressive symptoms. In addition to the background partial hospital treatment for alcoholism which lasted a mean of 21.2 days, study patients (n = 35) received cognitive-behavioral treatment for depression (CBT-D) or a control treatment consisting of relaxation training (RTC). While both groups showed improvement on dysfunctional attitudes during treatment, only the CBT-D group improved on measures of alcohol-related expectancies. Changes in cognitive variables during treatment predicted drinking outcomes, and the predictors of drinking outcomes varied across the two treatments. Among the RTC patients, changes in positive alcohol-related expectancies were negatively correlated with drinking frequency and quantity at follow-up. However, for the CBT-D patients, changes in self-efficacy concerning negative mood situations and negative alcohol-related expectancies were negatively correlated with drinking at longer-term follow-up. The results of this study provide evidence concerning the mechanisms by which the treatment modalities examined may affect patient outcome. Although these results are preliminary in nature, they do suggest that future research might examine efforts to capitalize on these mechanisms through the facilitation of changes found to predict better drinking outcomes in this study.

Patterns of change in depressive symptoms during smoking cessation: who's at risk for relapse?

The authors examined patterns of change in depressive symptoms during smoking cessation treatment in 163 smokers with past major depressive disorder (MDD). Cluster analysis of Beck Depression Inventory (A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) scores identified 5 patterns of change. Although 40% of participants belonged to clusters characterized by increasing depressive symptoms during quitting (rapid increasers, n = 31, and delayed increasers, n = 35), almost 47% were in clusters characterized by decreasing symptoms (delayed decreasers, n = 24, and rapid decreasers, n = 52). Both rapid and delayed increasers had especially poor smoking cessation outcomes. Results suggest that among smokers with an MDD history there is substantial heterogeneity in patterns of depressive symptoms during quitting and that patterns involving increased symptoms are associated with low abstinence rates.