Coping style as a risk factor for future alcohol use disorder: A 16-year longitudinal study in a Canadian military sample.

BACKGROUND: Coping strategies used in response to stress have the potential to influence the development of mental health disorders, including alcohol use disorders. The current study investigated whether coping strategies placed an individual at greater likelihood for developing a future alcohol use disorder. METHODS: This study used data from the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey; a nationally representative 16-year follow-up survey, with initial data collected in the 2002 Canadian Community Health Survey - Canadian Forces Supplement. The total sample from the two datasets included 2941 individuals who were Regular Force members in 2002. Coping styles included problem-focused, avoidant, and self-medication. Adjusted logistic regression analyses examined relationships between coping style (in 2002) and alcohol use disorders (developed between 2002 and 2018). RESULTS: Self-medication coping in 2002 was associated with any alcohol disorder since last interview (i.e., 2002-2018) (AOR 1.26; 95 % CI, 1.02-1.57) and during the past year (adjusted odds ratios [AOR 1.26; 95 % CI, 1.08-1.47]), as well as past-year binge drinking (AOR 1.19; 95 % CI, 1.09-1.29). Problem-focused coping was protective against past-year alcohol abuse (AOR 0.84; 95 % CI, 0.71-1.00) and any alcohol use disorder (AOR 0.87; 95 % CI 0.76-1.00). CONCLUSION: Coping styles were strongly associated with future alcohol use disorders. Notably, results show the risk extended over a 16-year period. Findings suggest the use of self-medicating coping strategies places an individual at increased risk of developing alcohol use disorders, while problem-focused coping may decrease future risk of alcohol use disorders.

Self-esteem mediates child abuse predicting adulthood anxiety, depression, and substance use symptoms 18 years later.

According to biopsychosocial models, experiencing parental child abuse increases susceptibility to adulthood psychopathology. However, there is a paucity of studies examining potential mechanisms of the parental child abuse and adulthood psychopathology relationship. The purpose of the current study was to determine if Time 2 (T2) trait self-esteem mediated levels of Time 1 (T1) retrospectively recalled parental child abuse predicting (T3) past-year major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), alcohol use disorder (AUD), and substance use disorder (SUD) symptoms. The 18-year Midlife Development in the United States (MIDUS) study included participants (N = 3294; T1 average age of 45.62 years) assessed at three different time points, each spaced about nine years apart. We performed structural equation mediation modeling analyses to determine how maternal and paternal child abuse at T1 would independently predict T3 MDD, GAD, PD, AUD, and SUD symptoms. We also examined whether T2 self-esteem mediated these relations while controlling for adulthood T1 psychopathology symptoms, demographics, socioeconomic status, somatic symptoms, and parental psychopathology. Consistent with our hypotheses, higher T1 maternal and paternal abuse predicted increased T3 GAD, PD, AUD, and SUD symptoms via diminished T2 self-esteem as the mediator (% proportion mediated = 33.0-100). However, childhood paternal, but not maternal, abuse predicted adulthood MDD symptoms via reduced self-esteem. Findings remained after adjusting for covariates. Our research highlights the importance of understanding retrospectively recalled parental child abuse-adulthood psychopathology relations, their potential mechanisms, and self-esteem as a malleable treatment target for adults with heightened child abuse.

Risk Factors of Alcohol Use Disorders Among Inpatients with Schizophrenia: An Institutional-Based Cross-sectional Survey.

Objective: This study aimed to elucidate the risk factors associated with alcohol use disorders (AUDs) among inpatients with schizophrenia at a specialized mental hospital in Baoding city, China. Methods: This cross-sectional survey comprised 301 comorbid patients. Three binary logistic regression models were used to investigate the factors linked to AUDs in patients with schizophrenia. Propensity score matching analysis was conducted to validate inconsistent variables identified by the regression models. Results: Significant differences were observed between the comorbid and non-comorbid groups concerning sex (P < .001), disposition (P = .049), smoking habits (P < .001), place of residence (P = .010), family relationships (P = .002), family history of mental disorders (P = .008), history of alcoholism (P = .003), onset latency (P = .005), impulsivity (P < .001), suicide or self-injury history (P < .001), and obvious aggressive behavior (P < .001) in univariate analyses. The area under the curve values for the three regression models were 0.83 (P < .001), 0.80 (P < .001), and 0.81 (P < .001), respectively. Binary logistic regression and propensity score matching analyses indicated that introverted disposition, smoking, acute onset, impulsivity, and suicide or self-injury history were independent risk factors associated with AUDs in inpatients with schizophrenia with an odds ratio of > 1. Conclusion: Introverted disposition, smoking, acute onset, impulsivity, and suicide or self-injury history were independently associated with the AUDs in inpatients with schizophrenia. Future studies should prioritize longitudinal studies to discern the evolving dynamics of potential confounding risk factors.

GET73 modulates lipopolysaccharide- and ethanol-induced increase in cytokine/chemokine levels in primary cultures of microglia of rat cerebral cortex.

BACKGROUND: - Alcohol-induced pro-inflammatory activation might influence cellular and synaptic pathology, thus contributing to the behavioral phenotypes associated with alcohol use disorders. In the present study, the possible anti-inflammatory properties of N-[(4-trifluoromethyl)-benzyl]4-methoxybutyramide (GET73), a promising therapeutic agent for alcohol use disorder treatment, were evaluated in primary cultures of rat cortical microglia. METHODS: - Primary cultures of cerebral cortex microglial cells were treated with 100 ng/ml lipopolysaccharide (LPS; 8 h, 37 °C) or 75 mM ethanol (EtOH; 4 days, 37 °C) alone or in the presence of GET73 (1-30 µM). At the end of the incubation period, multiparametric quantification of cytokines/chemokines was performed by using the xMAP technology and Luminex platform. Furthermore, cultured microglial cell viability following the treatment with EtOH and GET73, alone or in combination, has been measured by a colorimetric assay (i.e. MTT assay). RESULTS: - GET73 (10 and 30 µM) partially or fully prevented the LPS-induced increase of IL-6, IL-1ß, RANTES/CCL5 protein and MCP-1/CCL2 levels. On the contrary, GET73 failed to attenuate the TNF-α level increase induced by LPS. Furthermore, GET73 treatment (10-30 µM) significantly attenuated or prevented the EtOH-induced increase of TNF-α, IL-6, IL-1ß and MCP-1/CCL2 levels. Finally, at all the concentrations tested (1-30 µM), the GET73 treatment did not alter the EtOH-induced reduction of microglial cell viability. CONCLUSIONS: - The current results provide the first in vitro evidence of GET73 protective properties against EtOH-induced neuroinflammation. These data add more information on the complex and multifactorial profile of action of the compound, further supporting the significance of developing GET73 as a therapeutic tool for the treatment of individuals with alcohol use disorders.

[Impairment of executive functions in patients with alcohol use disorders]. / Narushenie ispolnitel'nykh funktsii u bol'nykh alkogol'noi zavisimost'yu.

OBJECTIVE: To study the features of executive functions in patients with alcohol use disorders and comorbid exogenous organic brain damage of non-alcoholic nature. MATERIAL AND METHODS: Sixty-five men, aged 24 to 55 years, with alcohol use disorders were examined. Thirty mentally healthy men were examined as a control group. To assess executive functioning, standard neuropsychological tests were used: the Go/No-Go task, the Corsi test and the Stroop Color Test. RESULTS: Patients with alcohol use disorders and comorbid exogenous organic brain damage made significantly more errors in the Go/No-Go task (skipping the Go signal: p=0.004) and performed the Stroop Color test longer (task completion time: p=0.003). According to multivariate regression analysis, the presence of exogenous organic brain damage predicted the worst indicators of psychomotor reaction (p=0.009) and cognitive flexibility (p=0.021). CONCLUSION: Comorbid exogenous organic brain damage in patients with alcohol use disorders leads to a significant deterioration of executive functions, including psychomotor reaction and cognitive flexibility, compared with patients suffering only from alcohol use disorders.

[Features of the implementation of 12-step treatment programs for Alcoholics Anonymous and other programs for the treatment of alcohol use disorders].

Alcoholism remains an urgent problem, as alcohol-related mortality is approximately 10 times higher than that from all drugs and accounts for 5.1% of the total global burden of disease. The solution to this problem is multifaceted and includes a wide range of medical services. The article on alcohol use disorders provides an overview of one of the largest support programs for people with alcohol dependence - Alcoholics Anonymous (AA). It is noted that the initial AA intervention includes work through social communication and the «12 steps¼ program. Its purpose is to facilitate internal psychological, emotional and spiritual changes that are considered necessary to maintain the status of abstinence from alcohol.

Alcohol-Specific Inpatient Diagnoses in Germany: A Retrospective Cross-Sectional Analysis of Primary and Secondary Diagnoses from 2012 to 2021.

AIMS: Our study aimed to a) describe the distribution of hospital discharges with primary and secondary alcohol-specific diagnoses by sex and age group, and b) describe how the number of hospital discharges with primary and secondary alcohol-specific diagnoses have changed across different diagnostic groups (categorized by primary International Classification of Diseases, 10th Revision [ICD-10] diagnosis) over time. DESIGN: Retrospective cross-sectional analysis. SETTING: German hospital settings between 2012 and 2021. PARTICIPANTS: All persons aged 15-69 admitted to hospitals as registered in a nationwide data set. MEASUREMENTS: We counted a) the number of all hospital discharges and b) the number of hospital discharges with at least one alcohol-specific secondary diagnosis (secondary alcohol-specific diagnosis) by year, sex, age group, and diagnostic group. One diagnostic group included all primary alcohol-specific diagnoses, while 13 additional groups aligned with ICD-10 chapters (e.g., neoplasms). Alcohol-involvement was defined as either a primary or secondary alcohol-specific diagnosis. FINDINGS: Of 95 417 204 recorded hospital discharges between 2012 and 2021, 3 828 917 discharges (4.0%; 2 913 903 men (6.4%); 915 014 women (1.8%)) involved either a primary or at least one secondary diagnosis related to alcohol. Of all alcohol-involved hospital discharges, 56.8% (1 654 736 discharges) had no primary but only a secondary alcohol-specific diagnosis. Secondary alcohol-specific diagnoses were particularly prevalent in hospital discharges due to injuries. With rising age, alcohol-involvement in hospital discharges due to digestive or cardiovascular diseases increased. Between 2012 and 2021, the rate of alcohol-involved hospital discharges has decreased more in younger as compared with older adults (average change between 2012 and 2021: 15-24: -55%; 25-34: -41%; 35-44: -23%; 45-54: -31%; 55-64: -21%; 65-69: -8%). CONCLUSIONS: The number of alcohol-involved hospital discharges in Germany from 2012 to 2021 more than doubles (from 1 654 736 to 3 828 917) when including secondary alcohol-specific diagnoses. More pronounced declines among younger adults may be attributed to unequal changes in alcohol consumption patterns across the population and to the hazardous effects of long-term alcohol use.

Use of Transdermal Alcohol Sensors in Conjunction With Contingency Management to Reduce Alcohol Consumption in People With Alcohol Dependence Attending Alcohol Treatment Services: Protocol for a Pilot Feasibility Randomized Controlled Trial.

BACKGROUND: Wearable technology for objective, continuous, and reliable alcohol monitoring has been developed. These are known as transdermal alcohol sensors (TASs). They can be worn on the wrist or ankle with the sensor pressed against the skin and can measure sweat vapors being emitted from the skin, to record transdermal alcohol concentration (TAC). Previous studies have investigated the accuracy and acceptability of the available TAS brands, but there has been little research into their use in people with alcohol use disorders (AUD). OBJECTIVE: This feasibility randomized controlled trial aims to explore the feasibility, strengths, and limitations of using a TAS to monitor alcohol consumption in individuals in treatment for AUD with or without contingency management (CM) to promote abstinence or low-level alcohol consumption. METHODS: The target sample size is 30 (15 randomized to each group). Participants will be recruited through poster adverts at alcohol services. Both groups (control and CM) will wear the TAS (BACtrack Skyn) for 2 weeks in the context of their usual treatment, meeting with the researcher every other weekday. In the last meeting, the participants will complete a postwear survey on their experience of wearing the TAS. The CM group will also receive small financial incentives for low or no alcohol consumption, as measured by the TAS. On days where the TAC peak is below a set threshold (<115.660 g/L), CM group participants will be rewarded with a £5 (US $6.38) voucher. There are financial bonuses if this target is achieved on consecutive days. The researcher will monitor TAC for each day of the study at each research visit and allocate financial incentives to participants according to a set reinforcement schedule. RESULTS: The first participant was enrolled in June 2023, and the last in December 2023. Data analysis is underway and is estimated to be completed by June 2024. A total of 32 participants were enrolled. CONCLUSIONS: Most TAS brands have had limited application in clinical settings, and most studies have included healthy adults rather than people with AUD. TAS has the potential to enhance treatment outcomes in clinical alcohol treatment. The accuracy, acceptability, and feasibility of TAS for people with AUD in clinical settings need to be investigated. This is the first study to use TAS in specialized alcohol services with diagnosed AUD individuals currently receiving treatment from a south London alcohol service. TRIAL REGISTRATION: ISRCTN Registry ISRCTN46845361; https://www.isrctn.com/ISRCTN46845361. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57653.

Association between impulsivity and depressive symptoms in recently detoxified patients with alcohol dependence.

Background: Depression and impulsivity are etiologically linked to alcohol dependence (AD) and are known to affect course and outcomes. The relationship between impulsivity and depressive symptoms has been investigated only in a few studies of individuals with AD. Aim: This study aimed to explore the association between impulsivity and depressive symptoms in patients with AD. Materials and Methods: Our study was conducted in the inpatient setup of a tertiary care psychiatry institute. The study design is cross-sectional. The Barratt Impulsiveness Scale (BIS-11) and stop signal task (SST) were used to assess levels of global impulsivity and behavioral impulsivity, respectively, among 60 recently detoxified inpatients with AD. The Hamilton Depression Rating Scale (HAM-D) was used to measure depressive symptoms. The results were analyzed to examine the association of depressive symptoms with impulsivity. Pearson's coefficient of correlation or Spearman's rank correlation and linear regression analysis were performed to explore the association between quantitative variables. Results: Patients with higher HAM-D scores were found to have significantly higher score on all three subscales of the BIS-11. The attention impulsivity subscale had the strongest correlations (r = 0.53, P < 0.001). Depressive symptoms were more strongly correlated with cognitive impulsivity (r = 0.54, P< 0.0001) compared with motor impulsivity and were not significantly associated with behavioral impulsivity. Adjusting for other variables, cognitive impulsivity was found to be the strongest predictor of the severity of depressive symptoms. Conclusions: The study showed a strong association between impulsivity and depressive symptoms in individuals with AD. This relationship may apply more to cognitive impulsivity, reflecting the role of impulsive decisions compared with impulsive actions.

Burden of non-communicable diseases attributed to alcohol consumption in 2019 for the Brazilian Unified Health System.

OBJECTIVE: To estimate the health and economic burden of non-communicable diseases (NCDs) attributed to alcohol consumption in 2019 for the Brazilian Unified Health System (SUS) stratified by states. STUDY DESIGN: Observational, descriptive, and ecological study. METHODS: We used population attributable fractions (PAFs) of NCDs due to alcohol consumption from the Global Burden of Disease study. We applied the PAFs to the costs of hospitalizations and outpatient procedures of medium to high complexity paid by SUS for each outcome, obtained from official databases. We also calculated the disability-adjusted life years (DALYs) and mortality caused by alcohol-related NCDs. We converted the costs into international dollars (Int$) using the purchasing parity power in 2019. RESULTS: Alcohol-related NCDs accounted for 8.48% of deaths and 7.0% of DALYs among men, and 1.33% of deaths and 1.6% of DALYs among women. The main diseases were substance use, digestive, and neoplastic diseases. The SUS spent Int$202.0 million on alcohol-related NCDs, mostly on hospitalizations. The highest health burden was observed in the states of the Northeast region, and the highest expenses in the states from the South. The burden and cost values varied by sex, age group, and state. CONCLUSION: The study showed that alcohol consumption has a significant impact on Brazilian population morbidity and mortality and SUS expenditures, especially among men. These results can support policies for the prevention and control of alcohol consumption and health promotion at the subnational level, prioritizing strategies that are more appropriate to local realities.

The effectiveness of an ultra-brief intervention in 1 min for hazardous drinking in a general hospital setting: A quasi-randomized pilot trial.

Objective: We investigated the effectiveness of an ultra-brief intervention (Ultra-BI) for patients with hazardous drinking behaviors admitted to a general hospital. Method: In a quasi-randomized controlled trial at a general hospital in Japan, we assigned participants to intervention or control groups based on the last digit of their patient ID (odd for intervention, even for control). The study included inpatients with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) scores of ≥5 for men and ≥4 for women. The intervention involved providing advice and feedback within 1 min, accompanied by a leaflet on alcohol-related issues (Ultra-BI). The control group did not receive any intervention. The primary outcome was average weekly alcohol consumption at 3 months postintervention. Results: The study included 68 participants. The intervention group showed a reduction in average weekly alcohol consumption by -69.7 g/week compared to the control group (95% confidence interval [CI] -145.7 to 6.3 g/week, p = 0.07). Post-hoc analysis, adjusting for baseline values, indicated a between-group difference of -78.7 g/week (95% CI -135.2 to -22.2 g/week, p = 0.007). Conclusion: This pilot trial suggests the potential effectiveness of the Ultra-BI in general hospital wards. Further large-scale studies are required to confirm these findings.

Rethinking the role of trazodone in the different depressive dimensions.

INTRODUCTION: The efficacy of trazodone for several psychopathologic dimensions of depression has been shown in the literature. Trazodone has been widely used in some clinical contexts (e.g. for insomnia and depression in the elderly). However, the role of trazodone in several aspects of depression is not well known. AREA COVERED: Eight experts from academic and medical centers across Italy met to identify the difficulties and barriers faced in daily clinical practice in the assessment and management of major depressive disorder and how the use of trazodone could address some unmet needs. The objective of the expert meetings and the present document was to increase knowledge of particular areas of treatment with trazodone. EXPERT OPINION: Evidence of the role of trazodone in patients affected by major depressive disorder with anxiety symptoms, insomnia, agitation, cognitive deficits, alcohol use disorders, physical comorbidities, and suicide risk has been identified, showing the effectiveness of trazodone in different presentations of major depressive disorder. The main characteristics of patients with depression for whom trazodone seems to be most effective have been identified, providing clinicians with information on possible uses of this drug in such population of patients.

A quantitative feedback intervention to reduce binge drinking in young adults.

OBJECTIVE: Existing binge drinking reduction interventions such as brief intervention and personalized normative feedback have shown modest impact. The purpose of this study was to evaluate the feasibility (recruitment and retention rates), acceptability, and preliminary efficacy testing of a short-term "know your numbers (KYN)" intervention on motivating young adults to reduce their engagement in binge drinking. METHOD: Young adults (N=94, mean age 21 years) with a history of binge drinking received a 4-week KYN intervention that included information about their U.S. Alcohol Use Disorders Test (USAUDIT) scores and the alcohol biomarker phosphatidylethanol (PEth) level in relationship to different risk levels of alcohol use. At baseline and 4-weeks, measures included USAUDIT scores, PEth levels, motivation (Alcohol Contemplation Ladder) and other drinking measures. Focus groups were conducted at 4-weeks for feedback on the KYN approach. RESULTS: The recruitment rate was 82.26% (retention rate 76.9%). At 4-weeks there was a 62% increase in contemplation scores (indicating higher motivation), a decrease in USADUIT scores with an increase in the percent of participants classified as low-risk drinkers. No differences were found between baseline and 4-week PEth levels or number of binge episodes. Focus group results revealed satisfaction with the KYN approach but the need to understand how PEth levels and USAUDIT scores corresponded to health consequences and alcohol use levels. CONCLUSIONS: Results from this pilot study support the acceptability and potential use of a KYN approach in helping young adults understand their drinking levels.

Genetic Polymorphism in Alcohol Metabolism and Drinking Behavior are Associated with Gastric Cancer Risk in Men.

Objective In recent years, there has been a growing focus on health risks associated with alcohol consumption. The present study investigated whether or not the genetic variant of aldehyde dehydrogenase 2 (ALDH2) influences the risk of gastric cancer among individuals identified as hazardous drinkers using the Alcohol Use Disorders Identification Test (AUDIT), which provides a comprehensive assessment of hazardous drinking behavior. Patients We enrolled men with hazardous drinking behavior (AUDIT score ≥ 8) who had undergone gastric cancer screening (either endoscopy or a barium X-ray examination of the upper gastrointestinal tract) between April 2013 and March 2020 within 1 year from entry and who had subsequently undergone at least one more gastric cancer screening up to March 2021. Functional single-nucleotide polymorphisms of ALDH2 (rs671) were measured using a direct TaqMan PCR method with unprocessed saliva. Results A total of 246 men were enrolled, comprising 193 individuals with active ALDH2 (ALDH2*1/*1) and 53 with less-active ALDH2 (ALDH2*1/*2). The cumulative incidence of gastric cancer in the less-active group was higher than in the active ALDH2 group (p=0.01, hazard ratio: 4.6, 95% confidence interval: 1.2-16.7). Alcohol consumption was lower in the less-active ALDH2 group than in the active ALDH2 group, although no marked difference was observed in the AUDIT score. Conclusion In individuals with hazardous drinking behavior, a heightened risk of gastric cancer was observed among those with less-active ALDH2 variants, even when their alcohol consumption was comparatively lower than in those with active ALDH2 variants.

Brief intervention for chronic liver disease patients with alcohol use disorder in a hepatology outpatient unit: Effects and limitations.

AIM: It is not uncommon to encounter outpatients in the hepatology department with harmful alcohol habits. When treating such chronic liver disease (CLD) patients, an adequate intervention method for harm reduction of alcohol use, such as brief intervention (BI) or BI and nalmefene, should be considered. This study aimed to elucidate the clinical effectiveness of BI for CLD patients affected by harmful alcohol use. METHODS: From June 2021 to 2023, 123 Japanese CLD outpatients (hepatitis B virus : hepatitis C virus : alcoholic liver disease : others = 32:18:42:31) with an Alcohol Use Disorders Identification Test (AUDIT) score of ≥8 at the initial interview and a repeat interview with AUDIT 9 months later were enrolled. Clinical features related to patient behavior following the initial AUDIT interview were retrospectively evaluated, and compared between patients without and with BI treatment. RESULTS: For the non-BI and BI groups, baseline AUDIT score (median 10 [interquartile range (IQR) 9-13] vs. 12 [IQR 10-17], p = 0.016) and relative change in AUDIT score (median 0 [IQR -3 to 2] vs. -3 [IQR -7 to 0], p < 0.01) showed significant differences, whereas there was no significant difference between the groups for AUDIT score at the time of the second interview (p = 0.156). Following BI, significant improvements were observed for items 1, 2, 3, 4, 5, 8, and 10 of AUDIT (each p < 0.05). CONCLUSION: Patients with an alcohol use disorder as well as those with alcohol dependency who received BI showed a significant decline in AUDIT score, although the score of the follow-up AUDIT indicated continued alcohol use disorder. In addition to BI, medication with nalmefene should be considered, based on individual factors.

Associations between child maltreatment and hospital admissions for alcohol and other substance use-related disorders up to 40 years of age: Results from the Childhood Adversity and Lifetime Morbidity study.

BACKGROUND AND AIMS: Evidence on the associations between child maltreatment (CM), alcohol use disorders (AUDs) and other substance use disorders (SUDs) comes largely from retrospective studies. These rely on self-reported data, which may be impacted by recall bias. Using prospective CM reports to statutory agencies, we measured associations between CM notifications and inpatient admissions for AUDs and SUDs up to 40 years of age. DESIGN, SETTING AND PARTICIPANTS: Observational study linking administrative health data from Queensland, Australia to prospective birth cohort data comprising both agency-reported and substantiated notifications of CM. MEASUREMENTS: Outcomes were inpatient admissions for AUDs and SUDs based on ICD-10-Australian modification (AM)-coded primary diagnoses. Unadjusted and adjusted logistic regression analyses were undertaken. FINDINGS: Ten per cent (n = 609) of the cohort had a history of agency-reported or substantiated CM notifications before age 15. These individuals had higher adjusted odds of being admitted for AUDs and SUDs. For AUDs, the adjusted odds of inpatient admission were 2.86 [95% confidence interval (CI) = 1.73-4.74] greater where there was any previous agency-reported CM and 3.38 (95% CI = 1.94-5.89) greater where there was any previous substantiated CM. For SUDs, the adjusted odds of inpatient admission were 3.34 (95% CI = 2.42-4.61) greater where there was any previous agency-reported CM and 2.98 (95% CI = 2.04-4.36) greater where there was any previous substantiated CM. CONCLUSIONS: People with a history of child maltreatment appear to have significantly higher odds of inpatient admissions for alcohol use disorders and other substance use disorders up to 40 years of age compared to people with no history of child maltreatment.

Prevalence of hazardous drinking and suspected alcohol dependence in Japanese primary care settings.

OBJECTIVE: We aimed to assess the prevalence of hazardous drinking and potential alcohol dependence among Japanese primary care patients, and their readiness to change and awareness of others' concerns. METHODS: From July to August 2023, we conducted a multi-site cross-sectional study as a screening survey for participants in a cluster randomized controlled trial. The trial included outpatients aged 20-74 from primary care clinics. Using the Alcohol Use Disorders Identification Test (AUDIT) alongside a self-administered questionnaire, we evaluated the prevalence of hazardous drinking and suspected alcohol dependence, patients' readiness to change, and their awareness of others' concerns. RESULTS: Among the 1388 participants from 18 clinics, 22% (95% confidence interval (CI): 20% to 24%) were identified as engaging in hazardous drinking or suspected of being alcohol dependent. As the AUDIT scores increased, so did their readiness to change. However, only 22% (95%CI: 16% to 28%) of those with scores ranging from 8 to 14 reported that others, including physicians, had expressed concerns about their drinking during the past year. For those with scores of 15 or higher, the figure was 74%. CONCLUSIONS: This study underscores the need for universal or high-risk alcohol screening and brief intervention in Japanese primary care settings. Trial registry UMIN-CTR (https://www.umin.ac.jp/ctr/) (UMIN000051388).

Understanding alcohol use and alcohol use disorders from a developmental psychopathology perspective: Research advances, challenges, and future directions.

As part of the special issue of Development and Psychopathology honoring the remarkable contributions of Dr Dante Cicchetti, the current paper attempts to describe the recent contributions that a developmental psychopathology perspective has made in understanding the development of alcohol use and alcohol-related problems over the lifespan. The paper also identifies some of the future challenges and research directions. Because the scope of this task far exceeds the confines of a journal length article this paper does not attempt a comprehensive review. Rather, it builds on an earlier review and commentary that was published in Development and Psychopathology in 2013, with a similar goal.)Building on that work and updating its conclusions and suggestions for future directions, the current paper emphasizes findings from the research areas that were identified for further study in 2013 and the findings that have been published since that time.

Pirfenidone ameliorates alcohol-induced promotion of breast cancer in mice.

Purpose: Alcohol consumption increases the risk of breast cancer and promotes cancer progression. Alcohol exposure could affect both processes of the mammary carcinogenesis, namely, the cell transformation and onset of tumorigenesis as well as cancer aggressiveness including metastasis and drug resistance/recurrence. However, the cellular and molecular mechanisms underlying alcohol tumor promotion remain unclear. There are four members of the mammalian p38 mitogen-activated protein kinase (MAPK) family, namely, p38α, p38ß, p38γ and p38δ. We have previously demonstrated alcohol exposure selectively activated p38γ MAPK in breast cancer cells in vitro and in vivo. Pirfenidone (PFD), an antifibrotic compound approved for the treatment of idiopathic pulmonary fibrosis, is also a pharmacological inhibitor of p38γ MAPK. This study aimed to determine whether PFD is useful to inhibit alcohol-induced promotion of breast cancer. Methods: Female adolescent (5 weeks) MMTV-Wnt1 mice were exposed to alcohol with a liquid diet containing 6.7% ethanol. Some mice received intraperitoneal (IP) injection of PFD (100 mg/kg) every other day. After that, the effects of alcohol and PFD on mammary tumorigenesis and metastasis were examined. Results: Alcohol promoted the progression of mammary tumors in adolescent MMTV-Wnt1 mice. Treatment of PFD blocked tumor growth and alcohol-promoted metastasis. It also significantly inhibited alcohol-induced tumorsphere formation and cancer stem cell (CSC) population. Conclusion: PFD inhibited mammary tumor growth and alcohol-promoted metastasis. Since PFD is an FDA-approved drug, the current findings may be helpful to re-purpose its application in treating aggressive breast cancer and alcohol-promoted mammary tumor progression.

Review article: Current indications and selection criteria for early liver transplantation in severe alcohol-associated hepatitis.

BACKGROUND: Alcohol-associated hepatitis (AH) is a severe inflammatory form of alcohol-associated liver disease (ALD) that carries a high mortality rate. Early liver transplantation for severe AH is increasingly available. However, specific criteria for referral and selection remain a subject of debate. AIMS: To provide a narrative review of the natural history, diagnostic criteria and indications for referral for early liver transplantation for severe AH. METHODS: We searched PubMed for articles published through August 2023. Key search terms were 'alcoholic hepatitis,' 'alcohol-associated hepatitis,' 'abstinence,' 'alcohol relapse,' and 'liver transplantation.' RESULTS: Previously, a six-month period of alcohol abstinence was required before patients with ALD were considered for liver transplantation. However, studies in recent years have demonstrated that, among carefully selected patients, patients who received early transplants have much higher survival rates than patients with similarly severe disease who did not undergo transplants (77% vs. 23%). Despite these successes, early liver transplantation remains controversial, as these patients have typically not undergone treatment for alcohol use disorder, with the ensuing risk of returning to alcohol use. CONCLUSIONS: While early liver transplantation for AH has survival benefits, many patients would not have received treatment for alcohol use disorder. An integrated approach to evaluating candidacy for early liver transplantation is needed.