Alcohol-dependent Patients Research Articles

Decreased expression of CD200 on peripheral blood leukocytes in alcohol dependence

Chronic alcohol use induces innate immune genes, which activate the innate immune system. Neuroimmune regulatory proteins [e.g., Cluster of Differentiation 200 (CD200)] are immune response regulators and are involved in balancing the immune response. This study aimed to investigate the expression of CD200 on the surface of peripheral blood leukocytes in patients with alcohol use disorder and compare them with controls. Fifty male patients with alcohol use disorder were included in the study. A baseline assessment was done, and alcohol use history, craving, and withdrawal scores were collected. A 2-mL venous blood sample was collected from cases and controls for immunophenotyping of CD200. The control group consisted of 50 participants with similar socio-economic backgrounds. The cellular expression of CD200 on total leukocytes (median ± IQR) [39.94 (28.85, 50.01)] in cases was significantly lower compared to controls [45.07 (37.70, 51.69)] (U = 896, p = 0.015). Expression of CD200 on lymphocytes in cases was negatively correlated with years of heavy drinking and this was statistically significant (r = −0.321, p = 0.023). The study indicates that cellular expression of CD200 on the surface of peripheral blood leukocytes is reduced in alcohol-dependent patients. This reduction can contribute to exaggerated immune activity, release of pro-inflammatory cytokines, chronic microglial activation, neuroinflammation, and neurodegeneration in alcohol dependence.

Value of inflammatory response and oxidative damage in the diagnosis of infections in severe alcoholic hepatitis

Severe alcoholic hepatitis is the most lethal complication in alcohol dependent patients. The concurrence of infections in these patients is very frequent. Both produce a systemic inflammatory response syndrome (SIRS), secondary to intense release of inflammatory cytokines, which can complicate the diagnosis. In our study, Interleukin (IL)-6 and IL-10 levels are higher in patients with SIRS (p<0.001 and p = 0.033, respectively). IL-4, IL-6, Interferon‐gamma (IFNγ), Tumor necrosis factor alpha (TNFα) and IL-17 levels correlate with liver function, as estimated by MELD-Na (p = 0.018, p = 0.008, p = 0.009, p = 0.016 and p = 0.006, respectively). Malondialdehyde (MDA), a product of lipid peroxidation and marker of cell damage, also correlates with liver function (p = 0.002), but not with SIRS or infections. Only elevated IL-6 correlates independently with the presence of infections (RR=1.023 IC 95% 1.000–1.047), so it may be useful for the correct diagnosis in these patients. Values greater than 30 pg/mL have a sensitivity: 86.7% and specificity: 94.7% for the diagnosis of infections.

Mortality and alcohol-related morbidity in patients with delirium tremens, alcohol withdrawal state or alcohol dependence in Norway: A register-based prospective cohort study.

Little is known about long-term consequences of delirium tremens (DT). This study aimed to compare all-cause and cause-specific mortality and alcohol-related morbidity between patients with: (i) DT, (ii) alcohol withdrawal state (AWS) and (iii) alcohol dependence (AD). A national longitudinal health registry study with linked data from the Norwegian Patient Registry and the Norwegian Cause of Death Registry. Norway. All patients registered in the Norwegian Patient Registry between 2009 and 2015 with a diagnosis of AD (ICD-10 code F10.2), AWS (F10.3) or DT (F10.4) and aged 20-79 years were included (n = 36 287). Patients were categorized into three mutually exclusive groups; those with DT diagnosis were categorized as DT patients regardless of whether or not they had received another alcohol use disorder diagnosis during the observation period or not. Outcome measures were: annual mortality rate, standardized mortality ratios (SMR) for all-cause and cause-specific mortality and proportion of alcohol-related morbidities which were registered in the period from 2years before to 1year after the index diagnosis. DT patients had higher annual mortality rate (8.0%) than AWS (5.0%) and AD (3.6%) patients, respectively. DT patients had higher mortality [SMR = 9.8, 95% confidence interval (CI) = 8.9-10.7] than AD patients (SMR = 7.0, 95% CI = 6.8-7.2) and AWS patients (SMR = 7.8, 95% CI = 7.2-8.4). SMR was particularly elevated for unnatural causes of death, and more so for DT patients (SMR = 26.9, 95% CI = 21.7-33.4) than for AD patients (SMR = 15.2, 95% CI = 14.2-16.3) or AWS patients (SMR = 20.1, 95% CI = 16.9-23.9). For all comorbidities, we observed a higher proportion among DT patients than among AWS or AD patients (P < 0.001). People treated for delirium tremens appear to have higher rates of mortality and comorbidity than people with other alcohol use disorders.

RETN gene polymorphisms interact with alcohol dependence in association with depression.

Previous studies suggest that alcohol dependence is associated with increased risk of depression. The occurrence of depressive symptoms is related to polymorphisms in various genetic regions. This study aimed to investigate the interaction of RETN gene polymorphisms (rs1477341, rs3745368) with alcohol dependence on depressive symptoms in adult male during acute alcohol withdrawal. A total of 429 male adults were recruited in this study. Alcohol dependence was assessed using the Michigan alcoholism screening test (MAST). Depression was assessed using the 20-item self-rating depression scale (SDS). Hierarchical regression analysis was used to evaluate the interaction between genes and alcohol dependence on depression. Region of significance (ROS) test was used to explain the interaction effect. The strong and weak forms of the differential susceptibility and diathesis models were used to determine which fits the data better. Our results showed that MAST scores were significantly positively associated with SDS scores (r = 0.23, p < 0.01) in alcohol-dependent patients during alcohol withdrawal. The interaction between genotype and alcohol dependence was significant (β = -0.14, p < 0.05) in a strong diathesis-stress model. Susceptibility for depression symptoms was associated with alcohol dependence in RETN rs1477341 A carriers. Specifically, those that showed more alcohol dependence and the A allele of RETN rs1477341 exhibited more depression symptoms. However, RETN rs3745368 had no significant interaction with alcohol dependence. The A allele of RETN rs1477341 may correlate with susceptibility to depression symptoms in alcohol-dependent individuals during acute alcohol withdrawal.

Effect of a multidisciplinary approach on hospital visit continuation in the treatment of patients with alcohol dependence.

Given the high dropout rates from initial treatment for alcoholism among patients with alcohol dependence, it is highly essential to prevent alcohol-dependent patients from early dropout. This study aims to investigate whether a multidisciplinary approach can help achieve continuous hospital visits for this patient population for initial treatment. This is a retrospective cohort study based on the medical records of all sequential alcohol-dependent outpatients who visited Sodegaura Satsukidai Hospital for alcoholism at least once between October 2017 and March 2019. The primary outcome was the difference in the rates of patients who achieved 6 and 12 months of continuous hospital visits following the first visit with and without the multidisciplinary approach. Of all the participants (n = 67), the female-to-male ratios for patients supported with and without the multidisciplinary approach were 6:30 and 5:26, respectively. It was found that the rate of alcoholic patients treated with the multidisciplinary approach (n = 33, 91.7%), who had continuous hospital visits, was significantly higher than that of those without (n = 12, 38.7%) (χ2 = 21.2, p < 0.0001) during the first 6 months of treatment. Similarly, the rate of alcoholic patients treated with the multidisciplinary approach (n = 29, 90.6%) having continuous visits was significantly higher than that of those who did not receive such support (n = 8, 25.8%) (χ2 = 27.3, p < 0.0001) during the first 12 months. A multidisciplinary approach can be used to reduce dropout from initial treatment among outpatients with alcohol dependence.

Characteristics of amplitude of low-frequency fluctuations in the resting-state functional magnetic resonance imaging of alcohol-dependent patients with depression.

The high comorbidity of alcohol use disorder and depressive disorder is associated with poor patient prognosis. The mechanisms underlying this comorbidity, however, are largely unknown. By applying the amplitude of low-frequency fluctuations parameter in resting-state functional magnetic resonance imaging, this study investigated changes in the brain functioning of alcohol-dependent patients with and without depression. Alcohol-dependent patients (n = 48) and healthy controls (n = 31) were recruited. The alcohol-dependent patients were divided into those with and without depression, according to Patients Health Questionnaire-9 scores. Amplitude of low-frequency fluctuations in resting-state brain images were compared among the alcohol-dependent patients with depression, alcohol-dependent patients without depression, and healthy controls groups. We further examined associations between amplitude of low-frequency fluctuations alterations, alcohol-dependence severity, and depressive levels (assessed with scales). Compared with the healthy controls group, both alcohol groups showed amplitude of low-frequency fluctuations enhancement in the right cerebellum and amplitude of low-frequency fluctuations abatement in the posterior central gyrus. The alcohol-dependent patients with depression group had higher amplitude of low-frequency fluctuations in the right cerebellum than the alcohol-dependent patients without depression group. Additionally, we observed a positive correlation between amplitude of low-frequency fluctuations value and Patients Health Questionnaire-9 score in the right superior temporal gyrus in the alcohol-dependent patients with depression group. Alcohol-dependent subjects showed abnormally increased spontaneous neural activity in the right cerebellum, which was more significant in alcohol-dependent patients with depression. These findings may support a targeted intervention in this brain location for alcohol and depressive disorder comorbidity.

Association Between Alcohol Dependence and Depressive Episode: Before and After Treatment of the Dependence

Background: Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems like anxiety, dependence and depression. The present study was conducted with an aim to determine the association between alcohol dependence and depressive episode before and after treatment for alcohol dependence.&#x0D; Materials and Methods: An observational study was conducted among all diagnosed alcohol dependent and depressed patients aged more than 18 years, attending to Psychiatry OPD of a Medical College in Kolkata for a period of one year. After getting permission from the local ethics body, initial assessment was done on first visit of the patients to the psychiatry OPD with a semi structured questionnaire for socio-demographic profile and using AUDIT, CIWA and HAM-D 17 scale for their mental status. Further assessments were done in between day 14 to day 16, next in between day 30 to day 35 and final assessment was done after 2 months using same scales. Relationship between depression with alcohol dependence were determined by Pearson corelation test and represented in the form of table and scatter plot. Changes in mean score of different scales before and after treatment was assessed by paired t test considering confidence interval (CI) of 95% and p value ≤ 0.05 as significant.&#x0D; Result: Out of 70 patients, almost 90% of them were below the age 45 years with male preponderance (94.3%). Paired t test result showed, association of mean scores of different scales, before and after treatment of dependence was statistically significant (p=0.00). Mean AUDIT score, mean CIWA score and mean HAM score for the patients were found to be decreased with advancement of treatment. Pearson correlation test revealed, moderate relationship between AUDIT score and HAMD17 score (0.522) and strong relationship between AUDIT score and CIWA score (0.789).&#x0D; Conclusion: If alcohol dependence is treated properly there will be automatically decreased prevalence of alcohol withdrawal and alcohol induced depressive episodes.

Ghrelin and impulsivity relationship in alcohol-dependent patients and healthy individuals.

Abundant research indicates that ghrelin hormone levels are associated with alcohol use and addiction. One of the mediators of this association may be impulsivity, which is one of the common traits observed in alcohol addiction and some eating disorders. This study evaluated participants with alcohol dependency and healthy volunteers to determine whether trait impulsivity and ghrelin levels are associated. This study analyzed trait impulsivity scores and fasting serum ghrelin levels of 44 males with alcohol dependency and 48 healthy male participants. The Barratt Impulsiveness Scale and the UPPS Impulsive Behaviour Scale (UPPS) were used to measure trait impulsivity levels. Penn Alcohol Craving Scale and Yale Brown Obsessive Compulsive Drinking Scale for heavy drinking were used to assess craving at the baseline and after the detoxification period. Alcohol-dependent patients' fasting ghrelin levels were significantly higher than that of healthy participants. Ghrelin plasma levels were positively correlated with UPPS total impulsivity scores and sensation-seeking among healthy individuals. In alcohol-dependent participants, there was a positive correlation between UPPS urgency scores obtained at the baseline and fasting ghrelin levels before and after the detoxification period. Ghrelin-impulsivity relationship could be observed in certain dimensions of impulsivity in both alcohol-dependent and healthy individuals and even independent of the effect of alcohol. Although the associated impulsivity dimensions differ in different groups, the results are parallel to other studies in terms of demonstrating the relationship between ghrelin and impulsivity.

Cue exposure for alcohol use disorders: A commentary on Kiyak et al. (2023)

While cue exposure therapy (CET) gives similar effects to cognitive-behavior therapies (CBTs) for Alcohol Use Disorder, it does not consistently add to effects of CBT alone. If the non-random trial of Nattala, Murthy, Leung, Rentala and Ramakrishna (2018) is omitted from the systematic review and meta-analysis of Kiyak, Simonetti, Norton and Deluca (2023), even average effects against less stringent controls are not substantial. Some trials have used sub-optimal versions of CET, but effects of CET are also constrained by the fact that many alcohol dependent patients do not exhibit strong craving. In vivo coping skills practice in the presence of powerful alcohol cues remains a viable treatment, especially if a key focus is on skills with wide situational application rather than solely on habituation. Multisensory motivational imagery for alcohol control represents one such strategy.

Study of Socio-economic, Biochemical and Clinical Predictors of Alcohol Withdrawal and Delirium Tremens in Patients of Alcohol Dependence in Indian Population

Abstract Background: Alcohol withdrawal syndrome (AWS) is associated with morbidity and mortality. Assessment of factors affecting AWS will help in early diagnosis and initiation of appropriate treatment, hence improving the prognosis. Aim: The present study was conceived and planned to assess the socioeconomic, biochemical, and clinical predictors of alcohol withdrawal and delirium tremens with alcohol dependence patients in the Indian population. Study Design: Longitudinal study. Methodology: The study includes 100 patients admitted for alcohol withdrawal. Participants were assessed for detailed history, physical and mental state examination, CAGE scale (Cut down, Annoyed, Guilty, Eye-opener), AUDIT scale (Alcohol Use Disorders Identification Test), PAWSS scale (Prediction of Alcohol withdrawal severity Score), MINIPLUS (Mini-International Neuropsychiatric Interview) scale and CIWA scale (Clinical Institute withdrawal Assessment of Alcohol) scoring along-with biochemical and hematological investigations. Statistical analysis was done by using SPSS version 20. Results: Mean age of the patients observed was 33.91 years (19-70 years). A significant association between increase of mean corpuscular volume (MCV) and total bilirubin levels (P= 0.208); highly significant association between low platelet counts, low potassium levels, serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP) and the development of delirium tremens and severity of alcohol withdrawal was observed (P&lt;0.05). CAGE (P&lt;0.014), AUDIT (P&lt;0.001), and CIWA scores has significant association (P&lt;0.001) with development of delirium and PAWSS showed good prediction (P&lt;0.007) with patients having severe alcohol withdrawal. Conclusion: Our study recommends that socioeconomic and biochemical factors and predictors can be considered for early diagnosis of severity of alcohol withdrawal and delirium tremens.

Cover Image

The cover image is based on the Original Article Glutamate levels in the ventromedial prefrontal cortex and resting-state functional connectivity within reward circuits in alcohol-dependent patients by Yiting Hu et al.,https://doi.org/10.1111/adb.13272.

Clinical Values of Serum Uric Acid Levels in the Occurrence of Cognitive Impairment in Alcohol-Dependent Patients.

Studies have confirmed that uric acid is involved in the regulation of cognitive function. This study aimed to investigate the expression of serum uric acid in alcohol-dependent patients and evaluate its clinical diagnostic value for cognitive impairment. Blood sample was collected for assessment of serum uric acid levels. Montreal Cognitive Assessment Scale scores were obtained to assess cognitive function. Anxiety and depression scores on the Symptom Check List 90 scale were used to assess mental health status. The alcohol-dependent patients were divided into non-cognitive impairment and cognitive impairment groups according to Montreal Cognitive Assessment Scale score, and the serum uric acid levels of these groups were analyzed. The receiver operating characteristic curve evaluated the diagnostic value of serum uric acid in cognitive impairment patients. Pearson correlation coefficient evaluated the correlation between uric acid and Montreal Cognitive Assessment Scale score, anxiety score, and depression score. Multivariate logistic regression analyzed the association between each index and cognitive impairment in patients. Serum uric acid was higher in patients than in controls (P < .001). Uric acid was significantly increased in cognitive impairment patients than in non-cognitive impairment patients (P < .001). Serum uric acid has certain diagnostic value in patients with cognitive impairment. Anxiety score and depression score were positively correlated with uric acid level, while Montreal Cognitive Assessment Scale score was negatively correlated with uric acid. Additionally, serum uric acid, Montreal Cognitive Assessment Scale score, and anxiety and depression scores were the risk factors for cognitive impairment in patients (P < .05). The abnormal expression of uric acid has a high diagnostic accuracy for distinguishing cognitive impairment from non-cognitive impairment.

Does selective inhibition training reduce relapse rates when added to standard treatment of alcohol use disorder? A randomized controlled trial.

Alcohol-dependent individuals tend to selectively approach alcohol cues in the environment, demonstrating an alcohol approach bias. Because approach bias modification (ApBM) training can reduce the approach bias and decrease relapse rates in alcohol-dependent patients when added to abstinence-focused treatment, it has become a part of regular treatment. Moreover, in selective inhibition (SI) training, responses to one category of stimuli (i.e., alcohol stimuli) are selectively inhibited in an adapted Go/No-Go task. SI-Training has been found to effectively devalue the inhibited category and to reduce consumption of alcohol among social drinkers. This study investigated whether SI-Training can further improve the effects of treatment as usual that includes ApBM, and if so, whether the effect is mediated by a devaluation of the inhibited alcohol stimuli. Abstinent alcohol-dependent inpatients (N=434) were randomly assigned to receive 6 sessions of either active (n=214, 32% female) or sham (n=220, 38% female) SI-Training, in addition to standard treatment that includes active ApBM. Ratings were used to assess changes in the evaluation of alcohol stimuli after the training. Relapse rates were assessed 3 and 12 months after treatment discharge. Alcohol stimuli were rated negatively before and after the training, and the training did not influence these ratings. Evaluation of nonalcoholic drinks became more positive after active SI-Training. Both ApBM and SI-Training showed the expected training effects on reaction times. Contrary to expectations, SI-Training conditions did not yield different abstinence rates 3 or 12 months after treatment. We found no evidence supporting the hypothesis that SI-Training amplifies the relapse-preventing effect of ApBM. Moreover, alcohol stimuli were rated negatively before and after treatment and were not influenced by SI-Training.

Glutamate levels in the ventromedial prefrontal cortex and resting-state functional connectivity within reward circuits in alcohol-dependent patients.

Great progress has been made in understanding the neural mechanisms associated with alcohol-dependent (AD) patients. However, the interactions within the reward circuits of the patients need further exploration. Glutamatergic projections from the prefrontal cortex to some brain regions are present in the reward circuit. However, little is known about the potential implications of glutamate levels in the prefrontal cortex on abnormal interactions within reward circuits in AD patients. To determine the potential roles of reward circuits in drinking, we investigated differences in resting-state functional connectivity (RSFC) and multivariate Granger causality analysis between 20 AD patients and 20 healthy controls (HC). The neuroimaging findings were then correlated with clinical variables (alcohol use disorder identification test). The ventromedial prefrontal cortex (VmPFC) is believed to play a critical role in addiction disorders, and glutamatergic projections from the prefrontal cortex to several regions of the brain are present in reward circuits. Proton magnetic resonance spectroscopy was also performed to assess the difference in glutamate levels in VmPFC between AD patients and HC. The results showed that the strength of functional connectivity in the reward circuit was generally attenuated in AD patients, and the reciprocal enhancement of activity between the right insula, left thalamus and VmPFC was found to be significantly greater in AD patients. It is worth noting that although glutamate levels in the VmPFC did not show significant differences between the two groups, the level of glutamate in the VmPFC was significantly correlated with RSFC. We hope that the current findings will help us to develop new intervention models based on the important role of the VmPFC in AD.

Depressive disorder comorbid with problematic alcohol use

IntroductionAlcohol use disorder is a real public health problem in the world, it consists of a pathological mode of consumption which is characterized by a loss of control and craving. Depressive disorder and alcohol use disorder are among the most frequent mental pathologies and are often associated.The links between these two disorders can be of several types: Alcohol Induced Depressive Disorders, Primary Depressive Disorders and Secondary Alcohol Dependence. They can also have two-way relationships or be favored by common factors.ObjectivesThe objective of our work is to analyze the causal links between alcohol use disorder and depression.Methodsprovide an update via two clinical vignettes and a review of the literature the relationship between alcohol use disorder and depressionResults The causal relationships between alcohol dependence and psychiatric disorders can be of several types which are not mutually exclusive: primary alcohol dependence, secondary psychiatric disorders, induced by alcohol. This is the case for the majority of depressive disorders encountered in alcohol-dependent patients; primary psychiatric disorders and secondary alcohol dependence; alcohol dependence and anxiety and/or depressive disorders are favored by common factors, in particular personality disorders, encountered in approximately 40% of alcohol-dependent patients. Whatever the direction of causation, alcohol dependence and psychiatric disorders worsen each other over time.Depression and alcohol use disorder are among the most frequent mental pathologies and are often associated.The optimal management of patients with dual diagnosis is so-called “integrated” management, simultaneously combining alcohol and psychiatric therapeutic approaches.ConclusionsAlcohol consumption impairs the prognosis of depression, increases the risk of suicide, impairs social functioning and increases recourse to the healthcare system.The optimal management of patients with dual diagnosis is so-called “integrated” management. Psychotherapeutic (individual and systemic), drug and psychosocial approaches would be necessary to maximize therapeutic success.Disclosure of InterestNone Declared

Evaluation of the success rate of various inpatient alcohol addiction treatment programs in the Czech Republic and their comparison

IntroductionHarmful alcohol use far exceeds other mental disorders in the proportion of patients who do not receive adequate treatment. Despite the long history of anti-alcohol treatment in Czech Republic, there is no published prospective study to this day, in which patients that underwent inpatient addiction treatment are compared to patients on the waiting list and only one prospective randomized study comparing two different medium-term inpatient programs was published.Almost all the studies published so far only bring results of particular hospitals. Differences in methodology, differences between cohorts of patients, absence of profiling and differences in therapeutic programs and historical changes makes comparison of results of those studies very difficult.ObjectivesThis work seeks to present and compare the data from studies that evaluate the success of medium-term inpatient treatment of alcohol dependent patients in the Czech Republic. Another aim was to identify problems that make such comparison difficult.MethodsBibliographia Medica Čechoslovaca and Pubmed was used to find studies published in professional medical journals since 1970, in which abstinence of patients who voluntarily completed medium-term inpatient treatment of alcohol dependence is evaluated.ResultsMedium-term inpatient treatment of alcohol addiction leads to one year abstinence in 34 to 76 % of patients. Such variance value is largely caused by different methodology of compared studies. In compared studies there are differences:1. in definition of abstinence2. if abstinence rate is assessed in all patients who have entered the treatment or only in those who have completed the treatment properly3. if abstinence rate is calculated using number of patients entering treatment or the number of patients who have been obtained by valid information (outpatient clinic, questionnaires)4. in the way the data was collected5. in the composition of patients6. in societal background, because there is large time gap present between compared studiesConclusionsThe comparison of individual studies presented many problems. Further steps should be taken to help compare treatment programs in the future, as they provide different therapeutic interventions in different intensity and length to different patients. Adequate patient profiling, detailed description of therapeutic interventions and identification of effective components of the therapeutic program is a way to support further research in this area, optimize existing programs and increase the overall efficiency of treatment.Disclosure of InterestNone Declared

Analysis of the influence of positive psychotherapy on the improvement of re drinking among alcohol dependent people from the perspective of ideology and politics

BackgroundAlcohol dependence is a chronic and recurrent brain disease of central nervous system poisoning caused by long-term excessive drinking. The prevalence of alcohol-dependence patients in China shows a rising trend year by year. Alcohol dependence will not only cause serious harm to patients’ physical health and mental state, but also affect their family relations and even entire social security. The study evaluated the improvement of psychological intervention measures on alcohol-dependent people’s rehydration in the context of the Great Thought Policy to help them better reduce alcohol dependence.Subjects and MethodsThe study selected 200 patients with alcohol dependence admitted to a provincial hospital. The patients were divided into an experimental group and a control group by the random number table method. Both groups were treated with the same drug intervention. Among them, the patients in the experimental group were treated under active psychotherapy, that is, the responsible nurse combined psychological knowledge with ideological guidance to guide the patients to quit drinking. The control group was given routine psychological intervention. The patients were investigated with Symptom Checklist 90 (SCL-90) and telephone follow-up. The data were processed with SPSS 17.0 statistical software, and P &lt; 0.05 indicated that the difference was statistically significant.ResultsResults showed that the rehydration rate and rehospitalization rate of the experimental group were lower than those of the control group, and the mental health status of the patients in the experimental group was significantly improved compared with the control group (P &lt; 0.05), indicating that the psychological measures under the ideological and political intervention can effectively control the patients’ emotions.Table 1.Comparison of rehydration rate, rehospitalization rate and psychological status of patients before and after the treatmentGroupsRehydration rateRehospitalization rateRehospitalization rate of rehydrationSCL-90Experimental group22 (22.00%)19 (19.00%)19/22 (86.36%)10.23±0.33Control group24 (24.00%)21 (21.00%)21/24 (87.50%)18.24±0.78χ2 values4.2623.2850.3963.298P values0.0040.0320.0410.002ConclusionsThe experimental results show that the combination of ideological guidance and positive psychological knowledge, and the guidance and intervention of patients can effectively reduce their alcohol relapse, improve the level of mental health, and achieve the effect of successful abstinence.

The Relationship between Selected Factors (Temperament, Bipolar Traits, Sleep Quality, Severity of Addiction) and Depressive Symptoms in Alcohol-Dependent Men.

Clinical and epidemiological studies have demonstrated a relationship between alcohol addiction and mood disorders. Alcohol-dependent patients with depression tend to demonstrate clinically more severe manic symptoms, which complicates the process of diagnosis and therapy. However, the predictors indicating the risk of mood disorders in addicted patients remain unclear. The aim of the study was to examine the relationship between personal dispositions, bipolar traits, depth of addiction, quality of sleep, and depressive symptoms in alcohol-dependent men. The study group comprised 70 men (age M = 46.06, SD = 11.29) diagnosed with alcohol addiction. The participants completed a battery of questionnaires: BDI, HCL-32, PSQI, EPQ-R and MAST. The results were tested using Pearson's correlation quotient and general linear model. The findings indicate that some of the studied patients are likely to have mood disorders of clinically significant severity. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in alcohol-dependent patients. Among the components of sleep quality, problems with falling asleep and waking up at night appear to be most strongly associated with depressive symptoms. The intensity of depressive symptoms may relate to the intensity of certain bipolar features, such as risk-taking activity and irritability. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in the studied group.

Behavioral and biochemical effects of alcohol withdrawal in female C3H/HeNRj and C57BL/6JRj mice.

Alcohol use disorder (AUD) is a major problem of our society and is often characterized and worsened by relapse. Prolonged alcohol exposure leads to numerous biochemical alterations that, upon cessation of alcohol intake, cause an array of immediate and lasting withdrawal symptoms. Acute withdrawal and neuroinflammation can be harmful in themselves, and lasting withdrawal symptoms contribute to relapse. Here, we conducted an initial feasibility study assessing several behavioral and neurochemical factors in female C3H/HeNRj (C3H) and C57BL/6JRj (B6) mice to determine which strain showed the clearest alcohol withdrawal symptoms during long-term abstinence and neurochemical alterations following re-exposure. Female C3H and B6 mice (n = 12 per group/strain) were intermittently exposed to alcohol-containing or control liquid diets for 3 weeks. Acute and prolonged withdrawal symptoms were assessed over a period of 3 weeks using a battery of behavioral test, comprised of alcohol self-administration, anhedonia, hyperalgesia, anxiety-like and depressive-like disturbances. Brain inflammation was measured by multiplex cytokine assay. Monoamine levels in the hippocampus and striatum, as well as exploratory analyses of cations levels in the cerebellum, were assessed by High-Performance Liquid Chromatography (HPLC). Both C3H and B6 alcohol-exposed mice displayed decreased saccharin intake or preference and higher stress levels assessed by ultrasonic vocalizations (USVs) recordings. B6 but not C3H alcohol-exposed mice also exhibited a slower decline of alcohol oral self-administration (OSA), hyperalgesia, elevated brain TNF-α and elevated serotonin turnover. Our findings highlight the suitability of the B6 strain to study the behavioral and neurochemical alterations caused by alcohol withdrawal and the potential efficacy of experimental treatments, not only in early detoxification, but also in prolonged abstinence. The feasibility of these assays is important because long-lasting withdrawal symptoms are often the main cause of relapse in alcohol-dependent patients.

Disrupted diurnal oscillations of the gut microbiota in patients with alcohol dependence.

Patients with alcohol dependence (AD) can exhibit gut dysbacteria. Dysbacteria may co-occur with disruptions of circadian rhythmicity of the gut flora, which can aggravate AD. Herein, this study aimed to investigate diurnal oscillations of the gut microbiota in AD patients. Thirty-two patients with AD, based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and 20 healthy subjects were enrolled in this study. Demographic and clinical data were collected by self-report questionnaires. Fecal samples at 7:00 AM, 11:00 AM, 3:00 PM, and 7:00 PM were collected from each subject. 16S rDNA sequencing was conducted. Wilcoxon and Kruskal-Wallis tests were performed to characterize alterations and oscillations of the gut microbiota. We found that β-diversity of the gut microbiota in AD patients oscillated diurnally compared with healthy subjects (p = 0.01). Additionally, 0.66% of operational taxonomic units oscillated diurnally in AD patients versus 1.68% in healthy subjects. At different taxonomic levels, bacterial abundance oscillated diurnally in both groups, such as Pseudomonas and Prevotella pallens (all p < 0.05). β-diversity of the gut microbiota in AD patients with high daily alcohol consumption, high-level cravings, short AD durations, and mild withdrawal symptoms oscillated diurnally compared with other AD patients (all p < 0.05). The gut microbiota in AD patients exhibits disruptions of diurnal oscillation, which may provide novel insights into mechanisms of AD and the development of therapeutic strategies.