Severity Of Alcohol Dependence Research Articles

A novel concurrent pictorial choice model of mood-induced relapse in hazardous drinkers.

This study tested whether a novel concurrent pictorial choice procedure, inspired by animal self-administration models, is sensitive to the motivational effect of negative mood induction on alcohol-seeking in hazardous drinkers. Forty-eight hazardous drinkers (scoring ≥7 on the Alcohol Use Disorders Inventory) recruited from the community completed measures of alcohol dependence, depression, and drinking coping motives. Baseline alcohol-seeking was measured by percent choice to enlarge alcohol- versus food-related thumbnail images in two alternative forced-choice trials. Negative and positive mood was then induced in succession by means of self-referential affective statements and music, and percent alcohol choice was measured after each induction in the same way as baseline. Baseline alcohol choice correlated with alcohol dependence severity, r = .42, p = .003, drinking coping motives (in two questionnaires, r = .33, p = .02 and r = .46, p = .001), and depression symptoms, r = .31, p = .03. Alcohol choice was increased by negative mood over baseline (p < .001, ηp2 = .280), and matched baseline following positive mood (p = .54, ηp2 = .008). The negative mood-induced increase in alcohol choice was not related to gender, alcohol dependence, drinking to cope, or depression symptoms (ps ≥ .37). The concurrent pictorial choice measure is a sensitive index of the relative value of alcohol, and provides an accessible experimental model to study negative mood-induced relapse mechanisms in hazardous drinkers. (PsycINFO Database Record

Impulsive Personality Traits Mediate the Relationship Between Adult Attention-Deficit/Hyperactivity Symptoms and Alcohol Dependence Severity.

While the role of attention-deficit/hyperactivity disorder (ADHD) as a risk factor for developing alcohol use disorder (AUD) has been established, the underlying pathways connecting the two are still not fully understood. Overlapping constructs such as impulsivity may explain the increased risk for developing AUD in individuals with ADHD. In this study, we assessed whether adult ADHD symptoms increase the odds of having a diagnosis of AUD. Furthermore, we tested whether facets of impulsivity explained the relationship between ADHD symptoms and alcohol dependence (AD) severity. In a logistic regression of 749 participants (464=AD, 285=controls), overall adult ADHD symptoms, and more specifically, symptoms of hyperactivity/restlessness and problems with self-concept, increased the odds of having a diagnosis of AD. Within the AD sample, we found that impulsivity mediated the relationship between adult ADHD symptoms and AD severity. In particular, negative and positive urgency meditated the relationship of overall adult ADHD symptoms, and symptoms of hyperactivity/restlessness and problems with self-concept with AD severity. These results highlight the importance of looking at cohorts of ADHD symptoms and facets of impulsivity to assess the risk of developing AUD. They also suggest potential avenues for intervention strategies in individuals with preexisting adult ADHD symptoms who are seeking treatment for AUD.

Cross Sectional Study on Characteristics of Bipolar Disorder Association with Alcohol Dependence in a Tertiary Care Center in South India

Bipolar disorders are commonly associated with other psychiatric disorders, which influence the course, severity and outcome of the disorder Aim: to study the association of alcohol dependence on bipolar disorder and to compare bipolar patients without alcohol dependence in tertiary care center in south India Methods: A total of 83 patients with age of 18-65 years who were admitted in the acute in-patient ward of the Institute of mental Health were administered M.I.N.I PLUS neuropsychiatric interview module and the patients who fulfil the diagnostic criteria for BPAD after ruling out the secondary causes of mood disorder were included in the study. The scales utilized to study the alcohol dependence association with bipolar disorder are in the form of illness variables and symptoms severity. Results: Group-A (n=42) patients with bipolar disorder and co-morbid alcohol dependence and group-B (n=41) patients with bipolar disorder without alcohol dependence (Group-B) was noted in our study. Strong positive correlation between severity of alcohol dependence score and YMRS score, functioning score, positive scale of PANSS and aggression scores noted and Only treatment adherence, family H/o BPD and family H/o alcohol dependence show significance in the present study. Conclusion: Increase in severity of alcohol dependence is associated with severity of Bipolar disorder.

Abortion and sex-related conditions in substance-dependent Brazilian patients.

Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpatient addiction treatment unit in São Paulo, Brazil, with a sample of 616 patients, aged 18-75. Sociodemographic data, sexual behavior, and dependence severity were evaluated in relation to induced abortion. Approximately 27% of patients reported having a history of abortion (themselves in the case of women or partners in the case of men). The mean age was 34.6±10.9 years old, 34.9% diagnosed with severe alcohol dependence, 33% were diagnosed with severe levels of dependence on other drugs, 69.6% were diagnosed cocaine users (inhaled and smoked), and alcohol was the drug of choice for 30.4%. Chances of having a history of abortion is greater for women than for men with a odds ratio (OR = 2.9; 95%CI: 1.75-4.76), (OR = 1.7; 95%CI: 1.09-2.75) of no condom use; (OR = 2.0; 95%CI: 1.35-3.23) of history of STI and (OR = 3.2; 95%CI: 1.29-5.73) use of morning-after pill. Drug- and alcohol-dependent patients have high-risk behaviours of sporadic use or no-condom use which contribute to unplanned pregnancy and induced abortion, making this vulnerable population a group which deserves special attention in sexual health prevention programmes and health promotion efforts for the reduction of induced abortion.

Correlation between Severity of Alcohol Dependence and Age of Onset of Alcohol Consumption Behaviour

Correlation between Severity of Alcohol Dependence and Age of Onset of Alcohol Consumption Behaviour

Does managing the consumption of people with severe alcohol dependence reduce harm? A comparison of participants in six Canadian managed alcohol programs with locally recruited controls

Managed alcohol programs (MAP) are intended for people with severe alcohol-related problems and unstable housing. We investigated whether MAP participation was associated with changes in drinking patterns and related harms. One hundred and seventy-five MAP participants from five Canadian cities (Hamilton, Ottawa, Toronto, Thunder Bay and Vancouver) and 189 same-city controls were assessed for alcohol consumption, health, safety and harm outcomes. Length of stay in a MAP was investigated as a predictor of drinking patterns, non-beverage alcohol consumption and related harms. Statistical controls were included for housing stability, age, gender, ethnic background and city of residence. Negative binomial regression and logistic regression models were used. Recently admitted MAP participants (≤2 months) and controls were both high consumers of alcohol, predominantly male, of similar ethnic background, similarly represented across the five cities and equally alcohol dependent (mean Severity of Alcohol Dependence Questionnaire = 29.7 and 31.4). After controlling for ethnicity, age, sex, city and housing stability, long-term MAP residents (>2 months) drank significantly more days (+5.5) but 7.1 standard drinks fewer per drinking day than did controls over the last 30 days. Long-term MAP residents reported significantly fewer alcohol-related harms in the domains of health, safety, social, legal and withdrawal. Participation in a MAP was associated with more frequent drinking at lower quantities per day. Participation was associated with reduced alcohol-related harms over the past 30 days. Future analyses will examine outcomes longitudinally through follow-up interviews, police and health care records.

Longitudinal Changes in Combat-Related Posttraumatic Stress Disorder Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Hazardous Alcohol Use: The Role of Avoidance Coping.

Military personnel who have experienced combat trauma are at risk for developing posttraumatic stress disorder (PTSD). A greater recognition of the complex array of vulnerability factors that contribute to PTSD severity has led researchers to examine other non-combat-related factors. This longitudinal study examined a number of pre-, peri-, and postdeployment factors hypothesized to contribute to PTSD symptomatology among returning Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans presenting with at least subthreshold PTSD symptoms and hazardous alcohol use in a primary care setting. Purported risk factors included childhood family environment, severity of combat exposure, postdeployment social support, alcohol dependence severity, and an avoidant coping style. At baseline, postdeployment social support and avoidant coping contributed to PTSD severity. Only avoidant coping was associated with changes in PTSD symptom at 1-year follow-up. Reducing avoidant coping may deter the maintenance of PTSD among veterans with PTSD symptoms and hazardous alcohol use.

Life events in past one year in alcohol-dependent patients presenting with relapse

ABSTRACTObjective: Stressful life events may be an important factor in relapse in alcohol-dependent patients. This study was carried out to examine the life events in past one year in alcohol-dependent patients presenting with relapse.Methods: Thirty consecutive patients, aged 18 to 60 years, ICD-10 Diagnostic Criteria for Research for alcohol dependence syndrome, with current relapse were assessed on Severity Alcohol Dependence Questionnaire (SADQ) to measure alcohol dependence severity level and Presumptive Stressful Life Events Scale (PSLES) to identify life events in past one year prior to the relapse.Results: The mean number of life events among patients in past one year was 3.06 (SD 1.81). The mean number of undesirable life events was significantly higher than desirable events (p < .001). The most common life event was financial loss or problems (43%), followed by large loan and marital conflict (27%).Conclusion: There were a mean of three life events in the year preceding relapse in patients with alcohol dependence. Psychosocial treatment targeting stressful life events could be useful adjunct in the management of alcohol dependence.

Posttraumatic stress disorder, symptoms, and white matter abnormalities among combat-exposed veterans.

Posttraumatic stress disorder (PTSD) is associated with abnormalities in functional connectivity of a specific cortico-limbic network; however, less is known about white matter abnormalities providing structural connections for this network. This study investigated whether the diagnosis and symptoms of PTSD are associated with alterations in fractional anisotropy (FA), an index reflecting white matter organization, across six, a priori-defined tracts. White matter FA was quantified by diffusion tensor imaging using 3T-MRI among 57 male, combat-exposed veterans with no history of moderate to severe head injuries or current alcohol dependence: 31 met criteria for PTSD and 26 were demographically comparable, combat-exposed controls without PTSD. Clinician-administered and self-report questionnaires assessed PTSD severity, dissociation, and mood. PTSD + veterans had significantly higher FA than exposed controls in the superior fronto-occipital fasciculus (SFOF) and borderline higher FA in the anterior corona radiata (ACR) and cingulum (CGC), controlling for age and neurovascular comorbidities. When lifetime alcohol use disorders was included, only the association of PTSD with SFOF-FA remained significant. Among PTSD + veterans, higher SFOF-FA was associated with greater mood disturbance, dissociative symptoms, and re-experiencing, while lower FA of the uncinate fasciculus (UF) was associated with greater mood disturbance symptoms. Compared to combat-exposed controls without PTSD, veterans with PTSD exhibited higher white matter FA in the SFOF, and a similar tendency in the ACR and CGC, tracts involved in conflict-processing and spatial attention. Prior alcohol use might explain the associations of PTSD with ACR-FA and CGC-FA but not the association with SFOF-FA.

Effectiveness of a national 'Minnesota Model' based residential treatment programme for alcohol dependence in Ireland: outcomes and predictors of outcome.

The aims of this study were (a) to examine the effectiveness of an inpatient treatment programme for alcohol dependence based on the 'Minnesota Model' and (b) to examine potential predictors of outcomes from such treatment. Demographics and data relating to psychosocial functioning of a group of individuals who commenced treatment for alcohol dependence were gathered at the point of treatment entry. These individuals were then followed up 6 months after they were to complete their inpatient treatment to establish their alcohol-related outcomes. Outcomes from treatment were identified as an index of treatment effectiveness and the outcome data were analysed to determine whether any of the baseline variables could be used to predict outcomes from treatment. Of those who were contacted at 6-month follow-up, 81.5% had a 'good outcome'. This represented 66.7% of the total group who participated in the study. The only variable that was found to predict outcomes at 6-month follow-up was severity of alcohol dependence at treatment entry, with more severe alcohol problems associated with poorer outcomes. This study provides evidence of the potential for a Minnesota-based treatment programme to be effective in helping people with alcohol dependence to reduce the amount of alcohol they consume and sustain this reduction beyond the treatment period.

Effectiveness of Mindfulness Based Body Scan Meditation: A Case Study of Alcohol Dependence Patient

The present study examines the effectiveness of body scan meditation of mindfulness based stress reduction on craving in patient with alcohol dependence. An inpatient of 36year old with diagnosis of alcohol dependence disorder as per ICD-10 DCR criterion was selected purposively, from Central Institute of Psychiatry, Ranchi. Following detoxification subject was evaluated for withdrawal symptoms, severity of alcohol dependence and craving. The subject was purposefully assigned for receiving body scan meditation, underwent 45 minutes guided meditation and 15 minutes discussion for one week. Patient showed significant reduction in craving after one week body scan meditation. Findings of current study shows that there is significant reduction in craving after one week of body scan meditation in alcohol dependence patient.

Who achieves low risk drinking during alcohol treatment? An analysis of patients in three alcohol clinical trials.

There is evidence that low-risk drinking is possible during the course of alcohol treatment and can be maintained following treatment. Our aim was to identify characteristics associated with low-risk drinking during treatment in a large sample of individuals as they received treatment for alcohol dependence. Integrated analysis of data from the Combined Pharmacotherapies and Behavioral Intervention (COMBINE) study, Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) and the United Kingdom Alcohol Treatment Trial (UKATT) using repeated-measures latent class analysis to identify patterns of drinking and predictors of low-risk drinking patterns during treatment. United States and United Kingdom. Patients (n=3589) with alcohol dependence receiving treatment in an alcohol clinical trial were primarily male (73.0%), white (82.0%) and non-married (41.7%), with an average age of 42.0 (standard deviation=10.7). Self-reported weekly alcohol consumption during treatment was assessed using the Form-90 and validated with biological verification or collateral informants. Seven patterns of drinking during treatment were identified: persistent heavy drinking (18.7% of the sample), increasing heavy drinking (9.6%), heavy and low-risk drinking (6.7%), heavy drinking alternating with abstinence (7.9%), low-risk drinking (6.8%), increasing low-risk drinking (10.5%) and abstinence (39.8%). Lower alcohol dependence severity and fewer drinks per day at baseline significantly predicted low-risk drinking patterns [e.g. each additional drink prior to baseline predicted a 27% increase in the odds of expected classification in heavy drinking versus low-risk drinking patterns; odds ratio=1.27 (95% confidence interval (CI)=1.10, 1.47, P=0.002]. Greater negative mood and more heavy drinkers in the social network were significant predictors of expected membership in heavier drinking patterns. Low-risk drinking is achievable for some individuals as they undergo treatment for alcohol dependence. Individuals with lower dependence severity, less baseline drinking, fewer negative mood symptoms and fewer heavy drinkers in their social networks have a higher probability of achieving low-risk drinking during treatment.

Pharmaco-TMS reveals specific GABAergic action of Quetiapine associated with depression remission in a case of comorbid bipolar and substance use disorders

We report a case of a 32-year-old male patient who suffered from bipolar depression complicated by severe alcohol dependence and chronic cannabis abuse. No medication could help him to control a strong craving leading to frequent relapse until off-label treatment by baclofen at high dosage (300 mg/day). The subject became completely abstinent in alcohol for several months. Thymic evaluation showed a major depressive episode with Beck Depression Inventory (BDI) score at 13/39. Treatment by quetiapine was then introduced at 300 mg/day. Motor cortical excitability was assessed before starting quetiapine and after 4 weeks of stable intake. A complete remission of depressive state was observed according to the BDI score at 2/39. Before quetiapine and under chronic and stable baclofen and cannabis consumption, we observed: – hugely lengthening of CSP in both hemispheres (right more than left), probably due both to baclofen and cannabis use; – absent SICI in left hemisphere and present SICI in right hemisphere in agreement with a major depressive disorder. Baclofen could also have accentuated SICI decrease via presynaptic inhibition action; – present ICF in left hemisphere and absent ICF in right side. These results may be consequence of SICI abnormalities described above. After quetiapine, we observed bilateral CSP shortening, SICI restoration in left hemisphere, and ICF restoration in right hemisphere. In summary, we observed for the first time normalization of cortical excitability associated with bipolar depression (i.e. deficit in motor cortical gabaergic transmission in left hemisphere) due to pharmacological intervention. This case shows the feasibility and the physiological insight of pharmaco-TMS, even in complex “real-life” clinical situations.

The Influence of Smoking and Smokeless Tobacco on the Progression, Severity and Treatment Outcome in Alcohol-Dependent Individuals.

The influence of tobacco use in alcohol-dependent individuals is not well understood, especially the role of snuffing, which is common in Northern Europe. The aim was therefore to investigate the influence of smoking and snuffing on the progression, severity and treatment outcome in alcohol-dependent individuals. The hypotheses were that concomitant tobacco use (i.e. smoking or snuffing) would enhance the progression and severity of alcohol dependence and be less beneficial for treatment outcome, relative to tobacco non-users. Alcohol-dependent individuals (n = 347) were recruited from three treatment units specialized in alcohol use disorders. Participants were interviewed about their current and past alcohol and tobacco use at treatment entry and at a follow-up interview 2.5 years thereafter. The tobacco users (smokers and snuffers) had an earlier alcohol debut compared to the tobacco never-users. Snuffers reported regular alcohol consumption and inebriation at an earlier age in contrast to smokers and tobacco never-users. There were no difference between the groups regarding treatment outcome. This study highlights the importance of studying not only the influence of smoking but also of snuffing on the progression, severity and treatment outcome in individuals with alcohol dependence.

Orexin/hypocretin receptor 2 (HCRTR2) in alcohol dependence diagnosis and severity: Role of HCRTR2 rs2653349 polymorphism

Orexin/hypocretin receptor 2 (HCRTR2) in alcohol dependence diagnosis and severity: Role of HCRTR2 rs2653349 polymorphism

Therapeutic interventions for alcohol dependence in non-inpatient settings: a systematic review and network meta-analysis (protocol)

BackgroundAlcohol dependence is common and serious cause of social and physical harm. However, the optimal management of those with moderate and severe alcohol dependence in primary and community care after detoxification remains unclear. The aim of this review is to evaluate the effectiveness of interventions for maintaining abstinence in people with alcohol dependence following detoxification.MethodsWe will systematically search electronic databases and clinical trial registries for randomized controlled trials (RCTs) examining the effectiveness of pharmacological and/or psychosocial interventions for maintaining abstinence in recently detoxified, alcohol-dependent adults. The searches will be complemented by checking references and citations from included studies and other relevant systematic reviews. No limitation on language, year, or publication status will be applied. RCTs will be selected using prespecified criteria. Descriptive information, study characteristics, and results of eligible RCTs will be extracted. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed.DiscussionThis network meta-analysis aims to appraise and summarize the total evidence of therapeutic interventions for alcohol-dependent patients that require support for detoxification and can be treated in the community. The evidence will determine which combination of interventions are most promising for current practice and further investigation.Systematic review registrationPROSPERO CRD42016049779

Relationship between insomnia and tobacco smoking in alcohol-dependent patients

IntroductionInsomnia and tobacco use are frequent and important problems in alcohol-dependent patients. However, the relationship between sleep problems and cigarette smoking was not thoroughly investigated in this population.AimThe purpose of the study was to investigate the relationship between tobacco smoking and severity of insomnia in alcohol-dependent patients in treatment. We also aimed at assessing other predictors of insomnia in this population.MethodsThe study group comprised 384 alcohol-dependent patients. Standardized tools were used to assess: tobacco dependence (Fagerström Test for Nicotine Dependence [FTND]), sleep problems (Athens Insomnia Scale [AIS]), severity of alcohol dependence (Michigan Alcohol Screening Test [MAST]) and drinking quantities before entering treatment (Timeline Follow Back [TFLB]). Other comorbid psychiatric symptoms were assessed using Brief Symptom Inventory (BSI) and Barratt's Impulsiveness Scale (BIS-11).ResultsThe study group included 79.1% of current smokers, 62% of participants reported insomnia (AIS). The mean FTND score was 6.05 ± 2.18. The multivariate regression analysis revealed that the severity of tobacco dependence was significantly associated with the severity of insomnia (FTND, beta = 0.140, P = 0.013). Other factors associated with insomnia that remained significant in multivariate model were severity of psychopathological symptoms (BSI, beta = 0.422, P &lt; 0.0005) and intensity of drinking (TLFB, beta = 0.123, P = 0.034).ConclusionTobacco use may predict severity of insomnia in alcohol-dependent patients. This finding may have important clinical implications and influence strategies applied in treatment of alcohol use disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The prevalence of psychiatric co-morbidities and relapses in males treated for alcohol dependence syndrome – Prospective study from tertiary de-addiction care unit in Kerala, India

Kerala has high percapita consumption of alcohol among the other Indian states.ObjectivesPrevalence of psychiatric comorbidities in alcohol dependence syndrome and association of severity of alcohol dependence, personality dimensions, motivation and short delay relapses.MethodsA prospective study in 91 male alcoholic patients for 2 months.ResultsTwo groups not relapsed (NR = 48) and Relapsed (R = 43) were comparable in age, SADQ severity score, average units of alcohol consumption and years of alcohol use. Average consumption was 17 units/day (500 mL spirits), age of onset before 25 years 87%, mean age 40 and severe alcohol dependence was in 57% of study population. Co-morbid nicotine use was 80.2% and in equal numbers in the relapsers and non-relapsers group.ConclusionsBipolar disorder was the most prevalent (19.8%) in the study population. About 53.8% had alcohol dependence as the primary diagnosis with no associated psychiatric comorbidities. Anxiety disorders (12%) and personality disorders (19.7%) were found more in the relapsers group. Anxiety symptoms seemed to be a risk factor for relapsing compared to other comorbidities in bivariate analysis (Pearson Chi2 5.998, P = 0.014). Psychoticism among relapsers were high (Pearson Chi2 4.901, P value 0.027, OR: 3.782, 95% CI: 1.103–12.958). Co-morbidities were not statistically significant in multivariate (Pearson Chi2 1.765, P = 0.184, OR: 1.755, 95% CI: 0.763–4.037). Severity of alcohol dependence in relapsers was not significant (Pearson Chi2 0.650, P = 0.722). Motivation levels of 62.8% of relapsers were low, 32.6% medium and only 4.7% reported high motivation (Pearson Chi2 11.846, P = 0.003). Poor motivation proved to be a risk factor for future relapse (P = 0.008, 95% CI: 1.266–4.648, SE.332).Disclosure of interestThe authors have not supplied their declaration of competing interest.

Readiness to change, insight and motivation in hospitalized alcohol-dependent patients in three countries

IntroductionAlcohol dependence is a serious problem in Central Europe and the treatment effect depends on level of patient's motivation. The theory of change assumes that therapeutic approaches should be adapted to the motivation stage.ObjectivesTo examine the state of readiness to change at the beginning and the end of inpatient 6-week and 12-week therapeutic program in Slovakia, Poland, and Czechia.AimTo compare readiness to change with insight and motivation. To find out, whether patients change during the therapeutic program and how this change leads to advances in treatment.MethodsA total of 380 inpatients were examined using Alcohol Use Disorders Identification Test (AUDIT), the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Readiness to Change Questionnaire (RCQ), and Demographic Questionnaire.ResultsMeasured by AUDIT, single patients declared higher severity of alcohol dependence than married or divorced patients. A majority of patients were at the stage of action (68.5%) or preparation (26.3%) according to RCQ at the beginning of the treatment. Readiness to change was higher at the end of both programs in terms of taking steps in married patients and in terms of Decreasing of Ambivalence in single patients. The results of the 6-week program appear to be slightly better than 12-week treatment.ConclusionsThe intention and motivation to treatment changed during therapy. Marital status may increase the active component for readiness to change, while passive component (decreasing the ambivalence) is observed in single patients. Duration of the program does not seem to be crucial for readiness to change.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Alcohol-related cue-reactivity predicts abstinence duration in individuals with severe alcohol-use disorders

IntroductionAlcohol use disorder (AUD) is an important global public health problem with complex aetiology and relapsing remitting course. Clinical measures of alcohol dependence severity and alcohol-craving, are largely unreliable in identifying individuals at high-risk for relapse. Functional human neuroimaging methods that employ symptom provocation paradigms have shown promise in identifying critical brain regions with cue-elicited alcohol-craving response.ObjectiveThe present study aimed at examining the utility of fMRI cue-reactivity (CR) in predicting relapse risk.MethodsThe study was conducted on inpatients of a tertiary care neuropsychiatric hospital. Thirty-two treatment-seeking right-handed men were recruited for the study after informed consent. Following detoxification and 3-day drug-washout period, they underwent a task-based fMRI while viewing images of alcohol-related and control cues presented to them using a previously validated fMRI paradigm. All patients received anti-craving medications (baclofen: 60–80 mg/d, n = 16; naltrexone: 50–100 mg/d, n = 16) and were prospectively followed-up till their first alcohol lapse.ResultsRandom-effect analysis using one-sample test revealed significant CR to alcohol-related cues (relative to implicit baseline) with activation in salience-reward related regions [insula, cingulate, dorsal striatum (DS)], visual-attention regions [occipito-temporal] and deactivation of default-mode regions [posterior cingulate (PCC)] (all significant at PFWE &lt; 0.05, whole-brain corrected). Cox-proportional hazard regressions revealed that greater CR in Insula (Chi2 = 10.33; P = 0.001; HR = 3.1; 95% CI = 1.5–6.3) and DS (Chi2 = 10.87; P = 0.001; HR = 2.8; 95% CI = 1.5–5.2) predicts faster subsequent time to first drink after accounting for the role of clinical measures.ConclusionThese findings indicate that CR can serve as potential marker to identify individuals at high-risk for relapse. Further examination of intervention-related CR change may aid in personalizing treatment of AUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.