Alcohol Dependence Syndrome With Bipolar Affective Disorder and Hypomanic Current Episode: A Case Report.

Studies have revealed that individuals with bipolar I and bipolar II have a past of substance abuse. The co-occurrence of bipolar disorder and alcoholism is frequent. Although various arguments have been put forward to explain the relationship between these disorders, it is still not fully understood. Since substance abuse is prevalent among bipolar patients, it would be beneficial to investigate the impact of substance abuse on clinical characteristics, as well as the progression of the illness. Thus, this study was carried out to investigate a case of alcohol dependence with bipolar disorder. A 49-year-old male visited the psychiatry outpatient department and then was admitted. The patient's chief complaints were alcohol consumption, cigarette smoking, daily drinking for 35 years, irritability/aggressiveness, boastful talk, overspending, and decreased need for sleep from the last 20 days. According to the literature, self-medicating with alcohol is not an effective treatment for alcoholism, unless it is being used to alleviate the psychological and neurochemical effects caused by alcohol. However, there has been limited research on how to treat individuals who have both alcoholism and another medical condition. A few studies have looked at the impact of medications like valproate, lithium, and naltrexone, as well as psychosocial interventions, in treating patients with bipolar disorder and alcoholism. However, more research is necessary to fully understand the best approach.

Circulating microRNA profiling identifies microRNAs linked to prediabetes associated with alcohol dependence syndrome.

BACKGROUND: MicroRNAs are abundant in serum and have emerged as important regulators of gene expression, implicating them in a wide range of diseases. The purpose of this study was to discover and validate serum miRNAs in prediabetes associated with alcohol dependence syndrome (ADS). METHOD: Serum samples from ADS patients with or without prediabetes and normoglycemic controls were subjected to microarray. Validation of identified candidate miRNAs was performed by RT-qPCR. Additionally, GO and KEGG pathway analyses were carried out to uncover target genes anticipated to be controlled by the candidate miRNAs. RESULTS: Notably, 198, and 172 miRNAs were differentially expressed in ADS-patients with or without prediabetes compared to healthy controls, and 7 miRNAs in ADS-patients with prediabetes compared to ADS-normoglycemic patients, respectively. Furthermore, hsa-miR-320b and hsa-miR-3135b were differentially expressed exclusively in ADS-patients with prediabetes, and this was further validated. Interestingly, GO and KEGG pathway analysis revealed that genes predicted to be modulated by the candidates were considerably enriched in numerous diabetes-related biological processes and pathways. CONCLUSION: Our findings revealed that ADS-patients with or without prediabetes have different sets of miRNAs compared to normoglycemic healthy subjects. We propose serum hsa-miR-320b and hsa-miR-3135b as potential biomarkers for the diagnosis of prediabetes in ADS-patients.

Assessing the Behavioral and Personality Changes in Alcohol Dependence Syndrome in Wardha, Central India.

Background Alcohol dependence syndrome occurs when the consumption of alcohol is uncontrollable. Most of the alcohol drinkers are usually males. There is a rise in the incidence of road traffic accidents under the influence of alcohol due to locomotor and cerebral dysfunction. Alcohol is a significant cause and contributing factor for domestic violence, family disharmony, and displeasure in families. Research studies have shown that after the lockdown of COVID-19, the consumption of alcohol decreased in India. This study was conducted to assess the behavioral and personality changes in alcohol dependence syndrome. Methods This study was conducted at a rural tertiary care hospital in Wardha, Maharashtra, Central India. Sixty-two males participated in the study. Out of which, 56 were included in the study. There were urban and rural participants in the study. The study was conducted for a period of six months. The participants who were being treated for alcohol withdrawal and alcohol dependence syndrome were included in the study. The individuals unwilling to participate in the research and those admitted to the intensive care unit were excluded from this study. The primary outcome measure of the study was to assess the behavioral and personality changes in alcohol dependence syndrome. Participants were screened using the Cut-Down, Annoyed, Guilty, and Eye-Opener (CAGE) and the Alcohol Use Disorders Identification Test (AUDIT) questionnaires. The diagnosis of alcohol dependence syndrome was made according to the International Classification of Diseases, Tenth Revision, (ICD-10) criteria. The participants were assessed using a self-report questionnaire. The parameters of assessment were aggressive behavior, domestic violence, workplace violence, verbal abuse, and variables including the forensic aspects of alcohol consumption, such as road traffic accidents, etc. Previous research and similar studies on factors related to alcohol dependence syndrome were compared to establish a conclusion for the study. Results Participants reported to have decreased psychomotor function upon alcohol consumption compared to the time they were not under the influence of alcohol. Aggressive behavior associated with irritability and agitation was observed in 89.28% (50 out of 56) participants. A total of 76.78% (43 out of 56) had road traffic accidents at least once under the influence of alcohol. Of the sample, 85.71% (48 out of 56) committed verbal abuse at the workplace and home as a result of aggression under the influence of alcohol. And 69.64% (39 out of 56) of the sample had memory loss after consumption of alcohol. Conclusion There are several behavioral changes in individuals who are alcohol dependent, which may affect their day-to-day activities and cause poor performance in the workplace. Participants in the study showed a notable positive relation between alcohol dependence syndrome and aggressive behavior, verbal aggression, domestic violence, memory loss, and road traffic accidents under the influence of alcohol. Alcohol dependence syndrome can be linked with decreased quality of life due to problems faced in daily activities like psychomotor functions, sleeping, etc. During the treatment of alcohol dependence or withdrawal from alcohol, individuals experience socio-behavioral changes. Cognitive behavior therapy, including cognitive neuroscience, can help in managing these behavior and personality changes in alcohol dependence syndrome.

Study of Cutaneous Manifestations in Alcohol Dependence Syndrome Patients in a Rural Tertiary Care Center in India.

Background: Chronic alcoholism is a multifactorial condition predisposed by environmental, social, and psychological factors. Alcohol dependence syndrome (ADS) can present with varied cutaneous and systemic manifestations. The effects of alcohol use include cutaneous infections, infestations, features of malnutrition, exacerbation of pre-existing dermatoses, and alcohol-related dermatoses. This study aimed to analyze and document cutaneous manifestations secondary to infections, infestations, malnutrition, and modifications of pre-existing dermatoses in ADS patients and investigate the correlation between the presence of cutaneous manifestations and duration and quantity of alcohol intake. Methods: The present observational study was carried out in the Department of Dermatology for a period of one year. A total of 172 male patients with ADS presenting with skin manifestations were included in the study. Detailed analysis of history, clinical examination, and relevant investigations were conducted. Findings: Out of 172 male patients with ADS, the most common dermatoses noted were infections (166, 96.5%) and features of malnutrition (161, 93.6%). Exacerbation of pre-existing dermatoses (101, 58.7%) and alcohol-related dermatoses (85, 49.4%) were also observed. Conclusion: Most of the dermatoses were significantly correlated with the quantity of alcohol intake than with its duration, implying that higher quantity of alcohol intake has more impact on cutaneous and systemic manifestations. Identifying the cutaneous manifestations in ADS patients plays an important role in recognizing the underlying systemic disorders which in turn facilitates early intervention and thereby prevents complications.

Prevalence and correlates of personality disorders in males with alcohol dependence syndrome undergoing inpatient treatment in a tertiary care hospital in South India.

Background: Globally, about half the patients with alcohol dependence syndrome have a comorbid personality disorder (PD). Indian studies that have explored this are sparse. Objectives: The present study was conducted to estimate the prevalence of personality disorders in individuals with alcohol dependence syndrome undergoing inpatient treatment and to determine the sociodemographic and clinical correlates of PDs in these patients. Methods: This cross-sectional observational study was conducted among the inpatients of the psychiatry department in a tertiary care teaching hospital. Adult male patients with DSM-IV TR diagnosis of alcohol dependence were evaluated for the presence of PDs using Structured Clinical Interview for DSM IV Axis II Personality disorders. The severity of alcohol dependence was assessed using the Severity of Alcohol Dependence Questionnaire. Results: One hundred male inpatients with alcohol dependence syndrome were recruited. Of them, 48 (48%) participants had at least one PD with a 95% confidence interval of 0.38-0.58. Antisocial and avoidant PDs were found in 26 (26%) and 13 (13%) patients, respectively. The mean age at first drink was lower in participants with PD when compared to those without any PD (18.13 ± 4.46 vs. 20.79 ± 4.61 years, respectively). Also, the amount of alcohol consumption per day was significantly higher in those with PD when compared to those without any PD (15.9 ± 6.81 vs. 13.17 ± 4.34 units per day). Conclusion: About half of males with alcohol dependence syndrome undergoing inpatient treatment had at least one PD. Antisocial and avoidant PDs were the most common PDs in this population. Individuals with comorbid PD had a lower age at first drink and higher daily alcohol consumption.

Design, development and pilot testing of 'Quest', a smartphone-based relapse prevention app for patients with alcohol dependence.

OBJECTIVE: To design, develop and pilot the 'Quest' app for smartphone-based relapse prevention for patients diagnosed with alcohol dependence syndrome (ADS). METHODS: Principles of relapse prevention and motivation enhancement were used to develop the Quest App. Four addiction psychiatrists reviewed the app using the "app evaluation framework". Thirty patients (> 18 yrs age) diagnosed with ADS, who had an Android smartphone, were fluent in writing and reading English and agreed to use the app regularly for the next three months were enrolled in this study. After initial treatment for intoxication/withdrawal and with written consent, patients in the study group (TAUQ) were requested to download the Quest application from a downloadable installation file. The usability and acceptability of Quest App amongst TAUQ patients was evaluated using the usability section of the mHealth App Usability Questionnaire (MAUQ). The short-term effectiveness at the end of three months was compared between TAUQ and comparison group who received Treatment as Usual (TAU). RESULTS: Both acceptability (65 %) and usability (5.8 out of 7) of the app were high. The patient groups (with or without Quest app) showed a significant reduction in drinking at 30, 60, and 90 days follow-up compared with their baseline number of drinking days. There was no significant difference between the two groups (with or without Quest App) in the median number of lapses and the median number of days of heavy drinking. CONCLUSIONS: This is the first attempt to develop a smartphone app and test its feasibility in preventing relapse among patients with ADS in the Indian population. Further validation of the app after incorporating feedback and testing on a larger sample size and multiple languages is required.

Prevalence of alcohol dependence syndrome in the patients of acute pancreatitis: A cross-sectional study.

Background: Acute pancreatitis (AP) is the main reason for mortality and morbidity. Numerous studies have shown a link between chronic alcohol usage and AP. However, there are few studies on the percentage of patients developing AP as a result of dependent patterns of drinking and associated risk factors. Aim: This study aimed to study the prevalence and impact of risk factors of alcohol dependence syndrome with AP patients hospitalized in tertiary care facilities. Materials and Methods: This is a cross-sectional observational study. Sociodemographic and clinical data were taken from patients with AP after consent. Eighty-five patients with AP who met the inclusion criteria were involved after each participant had clinical evaluation using the modified Marshall score, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire (SAD-Q). The outcomes were tabulated and analyzed using Statistical Package for the Social Sciences (SPSS) software. Results: 38.8% of patients with AP were found to have features of alcohol dependence syndrome. Higher values of mean corpuscular volume (MCV), serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), Gamma-glutamyl transferase (GGT), and uric acid were associated with a greater propensity to have AP. The severity of alcohol dependence syndrome and AP was not associated. Conclusion: AP is potentially a fatal disease. In this study, 38.8% of AP patients had alcohol dependence syndrome. There was no statistical association between the severity of AP and alcohol dependence syndrome, though high values of MCV, SGOT, SGPT, and GGT were at greater risk of developing AP. As a result, alcohol dependence syndrome should be examined in all individuals with AP.

An observational study on deliberate self-harm in individuals with alcohol dependence syndrome.

Context: Comorbidities in alcohol dependence syndrome (ADS) are often associated with poor treatment outcomes and high service utilization. Deliberate self-harm (DSH) in India is a silent epidemic. There is a shortage of research on individuals with ADS, psychiatric comorbidities, and DSH. Aim: To study DSH and psychiatric comorbidity in persons with ADS. Settings and Design: A cross-sectional study of 1-year duration is conducted in out patient department/indoor patient department of a tertiary care hospital. Methods and Material: Eighty-one individuals with ADS were selected purposefully. A semi-structured pro forma, the severity of alcohol dependence questionnaire, Mini-International Neuropsychiatric Interview (MINI), and Deliberate Self-Harm Inventory were administered for assessment. The statistical analysis used is as follows: correlation statistics and logistic regression. Results: Most subjects were married, belonged to upper-middle socioeconomic status, had at least secondary education, and had moderate alcohol dependence severity. Almost 3/4th of the subjects had at least one lifetime psychiatric disorder. A past episode of major depressive disorder was found in 47%. Nearly 20% of study subjects had a history of DSH, which was significantly associated with unmarried status, and earlier age of alcohol dependence. Marital status, educational level, and age of onset of alcohol dependence explain 64.3% of the variance in DSH attempts. Suicidality was significantly related to the presence of DSH. Conclusions: The study found a high prevalence of psychiatric disorders and a history of DSH in individuals with ADS. The study confirmed the association between DSH and suicidality and indicated a specific subpopulation of ADS who need thorough clinical assessments to recognize these psychiatric comorbidities and DSH.

Six-month course and outcome of treatment-seeking individuals with alcohol dependence syndrome.

Background: Despite the availability of several pharmacological and nonpharmacological treatments, a significant proportion of patients with alcohol dependence relapse to alcohol use after treatment. The objectives of this study were to determine the 6-month course and outcome in treatment-seeking individuals with alcohol dependence syndrome and to determine the sociodemographic and clinical correlates of the outcome in these patients. Materials and Methods: A longitudinal observational study was conducted in treatment-seeking male patients with alcohol dependence syndrome. Baseline sociodemographic and clinical details were gathered using a structured pro forma. The patients were followed up at 2 weeks, 1 month, 3 months, and 6 months. During the follow-up evaluation, abstinence status, number of abstinent days, and number of heavy drinking days were noted. Logistic regression was conducted to evaluate the factors associated with abstinence at 6 months. Results: Ninety-four patients were recruited for the study. The mean age of the participants was 43.98 years (standard deviation (SD) 10.68). Two patients were lost to follow-up. At the end of 2 weeks, 74 (80.43%) out of 92 participants remained abstinent. At the end of 1 month and 3 months, 59 (64.13%) and 38 (41.3%) participants of 92 were abstinent, respectively. At the end of 6 months, 26 (30.23%) of 86 patients were abstinent. Among those who were not abstinent at 6 months, the mean number of abstinent days was 113 (SD 51.62) days and the mean number of heavy drinking days was 56 (SD 51.62) days. Outpatients were found to have 2.91 times higher odds of remaining abstinent at 6 months when compared to inpatients. Conclusion: Nearly one-third of treatment-seeking patients with alcohol dependence syndrome remained abstinent at the end of 6 months. The locus of treatment was associated with abstinence at 6 months.

Curative effect observation among patients with alcohol dependence in rehabilitation period by grouping motivational interviewing.

Objective: To explore the effect of grouping motivational interviewing on psychological craving of patients with alcohol dependence in the rehabilitation. Methods: In this prospective study one hundred patients with convalescent alcohol dependence admitted to Hebei Province Veterans Hospital from October 2017 to June 2019 were randomly divided into two groups, the experimental group and the control group, 50 cases in each. The experimental group was administrated oxazepam as a replacement therapy and the motivational interviewing. The control group was administrated oxazepam as a replacement therapy and routine health education. Both groups continued treatment for three months. Curative effect was assessed before treatment, and two weeks, four weeks and three months after treatment by using Penn Alcohol Craving Scale (PACS), Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). Results: PACS, HAMD and HAMA in the experimental group were significantly lower than those in the control group (P < 0.05). Conclusion: Grouping motivational interviewing can effectively reduce the degree of psychological dependence on alcohol and improve the symptoms of anxiety and depression in patients with alcohol dependence during rehabilitation period.

The Activities of Zinc and Magnesium Among Alcohol Dependence Syndrome Patients: A Case-Control Study From a Tertiary Care Teaching Hospital in South India.

Introduction Alcohol dependence syndrome (ADS) is a medical condition characterized by regular and excessive consumption of alcohol. ADS is a brain disorder wherein people consume alcohol despite knowing the physical, social, and financial consequences. Zinc and magnesium are microelements that are essential in the proper functioning of human physiological and biological processes. However, the homeostasis of these microelements' is disturbed among ADS patients. The present study aims to assess Zinc and magnesium activities among ADS patients and age-matched controls. Methods The study included 100 ADS patients and an equal number of the control group and was conducted between August and September 2021. The study was performed after acquiring approval from the institutional ethics committee. All the study cases were patients attending the department of Psychiatry, RVM Institute of Medical Sciences & Research Centre who were diagnosed with ADS. Both groups used the colorimetric method on ERBA Chem 5+ semi autoanalyzer to estimate serum zinc and magnesium levels. Results Among the 100 cases of ADS, 84 (84%) were males, and 16 (16%) were females. Patients were between the age group of 20 and 68 (mean: 42.8 years). Of the 100 controls, 84 (84%) were males, and 16 (16%) were females with a mean age of 43.1 years. The activities of Zinc among ADS patients and the control group were 88.53±18.7 µg/dL and 144.9±38.47 µg/dL (p<0.0001), respectively. The activities of magnesium among the ADS patients and the control group were 1.96±0.46 mg/dL and 2.88±0.4 mg/dL (p<0.0001), respectively.  Conclusions The activities of Zinc and magnesium have been noted to be significantly lower among ADS patients. Because both these microelements play a vital role in human cells' metabolic and physiologic activities, therapeutic interventions to compensate for such deficiencies while managing ADS patients may prove beneficial.

Adjuvant treatment with repetitive transcranial magnetic stimulation in freshly diagnosed alcohol-dependence syndrome patients from an industry: An outcome study.

BACKGROUND: Studies have suggested that repetitive transcranial magnetic stimulation (rTMS) could be efficacious in the treatment of major depression and other psychiatric indications. Alcohol-dependence syndrome is difficult to treat, and the relapse rate is high, even following the standard treatment protocol. No study has been done so far in India for the use of rTMS as an adjuvant therapy in the relapse prevention of patients with alcohol-dependence syndrome. Hence, the current study is an open-label study to explore the same. AIM: The aim of this study was to study the feasibility of rTMS in alcohol-dependence syndrome patients, the side effects if any, and the number of relapses that they may suffer from vis-a-vis patients with standard treatment protocols. MATERIALS AND METHODS: In a prospective, open-label study design, 100 freshly diagnosed cases of alcohol-dependence syndrome were included, and after suitable randomization, half of them were given adjuvant rTMS along with standard treatment and the rest received only standard treatment. The rates of relapse into drinking were compared for both groups. The data were compiled and analyzed with appropriate statistical methods. RESULTS: Participants given adjuvant rTMS showed significantly less number of relapses into drinking compared to the control group on standard treatment for alcohol-dependence syndrome. CONCLUSION: In the present study, though the sample size is small, a significant change with this novel treatment has been found. Whether this change is maintained over a period of time is to be seen by other longitudinal studies.

[The role of saturated fatty acids in impaired lipid metabolism in patients with alcohol dependence syndrome]. / Rol' nasyshchennykh zhirnykh kislot v narushenii lipidnogo obmena u patsientov s sindromom zavisimosti ot alkogolya.

OBJECTIVE: To determine the content and role of saturated fatty acids (SFA) in lipid metabolism disorder in patients with alcohol dependence syndrome (ADS). MATERIAL AND METHODS: A total of 123 men were examined: 44 patients with ADS and 79 healthy people. The patients were examined on the 5-6 day after admission to the hospital. The content of saturated fatty acids (SFA) (caproic, caprylic, capric, undecyl, lauric, tridecane, myristic, pentadecanoic, palmitic, margarine, stearic, arachin, eicosanoic, behenic) was determined by gas-liquid chromatography. Quantitative calculation of SFA levels was carried out by the AgilentChemStationB.03.01 program (USA). The ratio of stearic to palmitic acid (C18:0/C16:0) was calculated. The study of the enzymatic activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyltransferase (GGT) was carried out by generally accepted standardized methods on a Cobas Mirra automated analyzer. RESULTS: In ADS patients, changes in the composition of SFA were found with an increase in the number of short-chain fatty acids (caproic acid by 52.2%, caprylic acid by 75.5%); medium-chain acids (capric acid by 47.9%, undecyl acid by 74.7%, lauric acid), but with a decrease in the concentration of long-chain acids (pentadecanoic by 5.1%, margarine by 34.7%, arachinic by 19.58%, eicosanoic by 26.6%, behenic by 5.1%). Less correlations between the fatty acid content and the parameters of the lipid transport system of blood serum were established in ADS patients compared to the controls. This indicates deep disorders of lipid metabolism. CONCLUSION: The results expand the understanding of the complex mechanisms of lipid metabolism disorders in ASD, which is important for secondary prevention. They also substantiate the need for a purposeful study of lipid metabolism disorders in patients with ADS at an earlier stage of the disease.

Tolerance of transcranial direct current stimulation in psychiatric disorders: An analysis of 2000+ sessions.

Transcranial direct current stimulation (tDCS), a non-invasive, neuromodulatory technique, is being increasingly applied to several psychiatric disorders. In this study, we describe the side-effect profile of repeated tDCS sessions (N = 2005) that were administered to 171 patients (156 adults and 15 adolescents) with different psychiatric disorders [schizophrenia [N = 109], obsessive-compulsive disorder [N = 28], alcohol dependence syndrome [N = 13], mild cognitive impairment [N = 10], depression [N = 6], dementia [N = 2] and other disorders [N = 3]]. tDCS was administered at a constant current strength of 2 mA with additional ramp-up and ramp-down phase of 20 s each at the beginning and end of the session, respectively. Other tDCS protocol parameters were: schizophrenia and obsessive-compulsive disorder: 5-days of twice-daily 20-min sessions with an inter-session interval of 3-h; Mild cognitive impairment/dementia and alcohol dependence syndrome: at least 5-days of once-daily 20-min session; Depression: 10-days of once-daily 30 min session. At the end of each tDCS session, any adverse event observed by the administrator and/or reported by the patient was systematically assessed using a comprehensive questionnaire. The commonly reported adverse events during tDCS included burning sensations (16.2%), skin redness (12.3%), scalp pain (10.1%), itching (6.7%), and tingling (6.3%). Most of the adverse events were noted to be mild, transient and well-tolerated. In summary, our observations suggest that tDCS is a safe mode for therapeutic non-invasive neuromodulation in psychiatric disorders in adults as well as the adolescent population.

[Socio-demographic indicators of alcohol dependence in patients treated for addiction in a post-industrial city]. / Wskazniki socjodemograficzne uzaleznienia od alkoholu u osób leczonych odwykowo w miescie postindustrialnym.

BACKGROUND: The aim of the study was to evaluate the influence of the place of living on the prevalence of the alcohol dependence syndrome (ADS) and to find its possible connections with socio-demographic data within a post-industrial city with a population > 100 000 inhabitants. MATERIAL AND METHODS: The study was carried out in 2004-2012 on a group of 431 patients living in Bytom with diagnosed ADS treated either in psychiatric wards or in outpatient psychiatric clinics. The patients' gender, age, employment, marital status, level of education and the fact of living in a given town district were analysed. The majority of the demographic data was obtained from the City Office. RESULTS: The study demonstrated the influence of the place of living, age, gender, level of education and employment on the prevalence of ADS in a post-industrial city. CONCLUSIONS: Alcohol addicts who seek treatment are predominantly men > 40 years of age, with low education, mostly unemployed, living in the urbanized districts within the city center or the post-industrial area of the city, which are the areas with the highest risk of ADS. Living in a suburban neighborhood may protect against alcohol addiction due to the lower risk of exposure to environmental factors contributing to the prevalence of ADS. Additional protective factors include at least secondary education and paid employment prospects. The neighborhood of people with ADS has a particularly devastating effect on women, who are more likely to become addicted in such environments. Med Pr. 2019;70(2):221-8.

Serotonin transporter gene linked polymorphism (5-HTTLPR) determines progredience of alcohol dependence in Belarusian young males.

PURPOSE: Allelic duality and functional impact of degenerate repeat at 5'- flanking promoter region in SLC6A4 gene of the serotonin transporter (5-HTTLPR), have been in the focus of investigations over the years. Various outcomes regarding an association of its polymorphism with risks of alcohol dependence syndrome (ADS) were presented. Such studies have not been conducted in the Eastern European population e.g. Belarus. We therefore checked: the association of 5-HTTLPR polymorphism with ADS, and functional impact of the polymorphism on progredience of ADS in Belarusian population. MATERIAL AND METHODS: The study involved 499 Belarusian males: 377 subjects with ADS (AG), and a control group (CG) with 122 subjects without alcohol-related problems. The ADS group was further divided into two groups of individuals with rapid (AG (R)) and delayed (AG (D)) progression of ADS. Clinical diagnosis was carried-out using ICD-10 criteria, Belarusian Addiction Severity Index, "B-ASI" and Alcohol-Use-Disorders-Identification-Test (AUDIT). PCR-RFLP analysis was performed. RESULTS: There were no significant differences in the distribution of frequencies of either the 5-HTTLPR genotype or the short and long allele among AG and CG. However, the ADS 5-HTTLPR genotype and allele distribution frequencies differ significantly by the variation in progression of ADS. CONCLUSIONS: There is no significant association between polymorphism of serotonin transporter gene and risk of ADS. However, the polymorphism significantly determines progredience of ASD in subjects with pathological patterns of alcohol consumption. Findings from this study carry preliminary significance as a facility to effective alcohol addiction treatment, rehabilitation and preventive services in the Eastern Europe.

To identify predictors of relapse in cases of alcohol dependence syndrome in relation to life events.

BACKGROUND AND OBJECTIVES: Relapse is a complex and dynamic phenomenon that appears to be determined by biological, psychological, and social factors and an interaction among these. This study examined the association between demographic variables, clinical parameters, and psychosocial factors that predict the vulnerability to relapse in cases of alcohol dependence syndrome. MATERIALS AND METHODS: Structured assessments of clinical/demographic parameters, relapse precipitants, life events, and dysfunction were carried out among patients with alcohol dependence syndrome (n = 100) who had relapsed and compared with those (n = 100) who had managed to remain abstinent. RESULTS: Patients who had relapsed were found to have significantly more positive family history of substance use, past history of alcohol-related comorbidity, experienced a higher number of undesirable life events, and higher negative mood states and social anxiety and dysfunction in social, vocational, personal, family, and cognitive spheres compared to patients who had remained abstinent. CONCLUSIONS: Relapse in alcohol dependents is an interaction of many factors, and multiple layers of assessment may be required to predict relapse. This study provided further evidence in support of the importance of certain clinical/psychosocial factors in relapse in substance dependence. It provides the basis for investigating the correlates of relapse in a wide range of behavioral and substance use problems.

Risk of relapse in clients with alcohol dependence syndrome in a tertiary care hospital.

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.

Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: A cross-sectional study.

BACKGROUND: Contrary to the popular belief concerning the aphrodisiac effects of alcohol, there exists scientific evidence which conclude on sexual dysfunction caused by chronic alcohol use. There is a dearth of studies from India. AIM: The aim is to estimate the prevalence and correlates of sexual dysfunction in alcohol-dependent patients and to explore the association between sexual dysfunction and various alcohol-related variables. MATERIALS AND METHODS: The study employed a cross-sectional descriptive design and recruited 84 male patients admitted for de-addiction in a tertiary care center. The evaluation was conducted using a specially designed intake proforma and tools such as Severity of Alcohol Dependence Questionnaire, Arizona Sexual Experience Scale, and International Classification of Disease, 10th revision, diagnostic criteria for research. RESULTS: Thirty-seven percent of the patients had sexual dysfunction - the most common type being erectile dysfunction (25%), followed by dysfunction in satisfying orgasm (20%) and premature ejaculation (15.5%). Sexual dysfunction was significantly associated with the duration of alcohol dependence, amount of alcohol consumed per day, and severity of alcohol dependence. CONCLUSIONS: Sexual dysfunction is common in male patients with alcohol dependence. The study highlights the detrimental effects of alcohol on sexual function and this information can be utilized in motivational interviewing of patients with alcohol dependence syndrome.

Female-male differences in alcohol dependence levels: Evidence on newly incident adolescent and young-adult drinkers in the United States, 2002-2014.

OBJECTIVE: In this study of newly incident drinkers (NIDs), we (a) investigate and calibrate measurement equivalence of 7 clinical features of an alcohol dependence syndrome (ADS) across sex and age-of-onset subgroups and (b) estimate female-male differences in ADS levels soon after taking the first full drink, with focus on those with first full drink before the 24th birthday. METHODS: The study population is 12- to 23-year-old NIDs living in the United States (n = 33,561). Calibrated for measurement equivalence, male-female differences in levels of newly incident ADS are estimated for 6 age-of-onset subgroups. RESULTS: Measurement equivalence is achieved by dropping the "difficulty cutting down" item. Then, among early-adolescent-onset NID, females have higher ADS levels (for 12- to 13-year-old NID: ß = .25; 95% CI [0.05, 0.45]). In contrast, when drinking onset is delayed to adulthood, males have higher ADS levels (e.g., for 18- to 19-year-old NID: ß = -.27; 95% CI [-0.52, -0.02]; for 20- to 21-year-old NID: ß = -.38; 95% CI [-0.65, -0.12]). CONCLUSIONS: In the United States, there is female excess in ADS levels measured soon after drinking onset in early adolescence. The traditional male excess is seen when drinking onset occurs after mid-adolescence. Evidence from other countries will be useful.