Alcohol Dependence Syndrome Patients Research Articles

“I Don’t Mind Them Drinking, as Long as…”: A Cross-sectional Study to Identify Codependence among Primary Caregivers of Patients with Alcohol Dependence in Urban India

Abstract Background: Codependence is a form of relationship addiction, described as a “disease of lost selfhood.” Codependence among primary caregivers adversely impacts treatment outcomes in Alcohol Dependence Syndrome (ADS) patients. Personality traits of the caregiver may also influence codependency and its severity. However, in routine clinical practice, codependence among primary caregivers of alcoholic patients is not assessed and addressed. This study aimed to identify codependence among caregivers of ADS patients and determine its association with personality traits in various subgroups. Materials and Methods: A cross-sectional study was conducted in a private mental health establishment in urban Karnataka, India, among 125 adult primary caregivers of ADS patients who were spending at least 4 h daily with the patient for more than a year. Spann-Fischer codependence scale and Big Five personality inventory were used to assess codependence and personality domains, respectively. Codependence scores were correlated with Big Five personality scores and examined in various subgroups. Results: Among 125 study participants, 103 (82.4%) were female and 81 (64.8%) were spouse of ADS patients. Moderate and high codependency was found in 86 (68.8%) and 38 (30.4%) participants, respectively. Codependence was found to be significantly higher among females (64.5 ± 7.7) than males (57.6 ± 10.9), (t = −2.8, df = 25.6, P = 0.000), independent of the type of relationship with the patient. There was a significant positive correlation with neuroticism personality trait. Sociocultural and economic conditions of the caregiver also contributed to codependence. Conclusions: The study identified the presence of moderate-to-severe codependence, especially among female caregivers of ADS patients. This emphasizes the need for a protocol to assess codependency and personality traits among caregivers of ADS patients to improve treatment outcomes in urban Indian settings.

Therapeutic benefit of probiotic in alcohol dependence syndrome: Evidence from a tertiary care centre of India

Probiotic adjuvant has promising effects in treating alcohol induced hepatitis, depression, and anxiety. This study aimed to assess the effectiveness of adjuvant probiotic use in improving the liver functions, anxiety, and depression among patients with alcohol dependence syndrome (ADS) in a tertiary care hospital in Andhra Pradesh, India. In this prospective observational design, ADS patients with or without probiotics were followed-up at one and three months after initiation of treatment. They were assessed for liver function test (LFT), anxiety by HAM-A and depression by HAM-D scale. A total of 120 patients complied with the treatment, 60 in each group, mean age being 35.0 years (SD 9.5 years). The baseline socio-demographic and clinical characteristics were similar in both the groups. Significant reduction was noted in the probiotic group for total bilirubin (Mean difference (MD) 0.18; 95 % CI: 0.04, 0.31), AST (MD 5.0; 95 % CI: 0.5, 9.5), and ALT (MD 8.6; 95 % CI: 1.4, 15.7) at one month after treatment. Both the groups showed a considerable change in anxiety and depression scores (HAM-A and HAM-D) till three months. At three months of treatment initiation, proportional improvement of severity grade to mild form in anxiety was more in the probiotic group (35 %) than the non-probiotic group (13.3 %) (p < 0.05). Hence, probiotic supplementation can significantly reduce the hepatic enzymes and depression severity in patients with alcohol dependence syndrome but demands additional robust evidence on the causal inference.

Efficacy of tDCS on craving in patients of alcohol dependence syndrome: A single-blind, sham-controlled trial.

Craving is attributed as one of the main reasons for relapse in alcohol dependence syndrome. Neurostimulation techniques targeting craving in substance use disorders are being researched. Neuroimaging has shown dorsolateral prefrontal cortex (DLPFC) as one of the potential targets responsible for craving, with frontal dysfunction being quintessential in alcohol use disorder. Evidence suggests that stimulation of DLPFC with low-dose current can help in reducing craving. To study the effectiveness of transcranial direct current stimulation (tDCS) on craving in patients with alcohol dependence syndrome. We performed a single-blind, sham-controlled study involving 76 patients with alcohol dependence syndrome (according to ICD-10 DCR). Participants with Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal (CIWA-Ar) scores less than 10, not on any anti-craving medications were included in the study. Patients were allocated to active and sham tDCS groups in a ratio of 1:1. Such that 38 patients received active, and 38 patients sham tDCS stimulations; with anode as right DLPFC and cathode as left DLPFC receiving 2 mA current (twice daily session, total of 10 sessions). The Alcohol Craving Questionnaire (ACQ-NOW) was administered to measure the severity of alcohol craving at baseline and after the last tDCS session. Our study showed a significant reduction in craving in the Post-tDCS, ACQ-NOW scores as compared to sham tDCS. There was a significant reduction in the compulsivity and emotionality domain of craving after tDCS. The effect size for treatment with time interaction was (0.58). tDCS was superior to sham in reducing caving in patients with alcohol dependence syndrome.

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

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

Psychological hardiness, personality factors and coping styles in male patients of alcohol dependence syndrome

BackgroundAlcohol dependence syndrome (ADS) is a result of complex interplay between biological, psychological, and sociocultural factors. While the biological (genetic) factors remain non-modifiable, better understanding of individual hardiness, personality variables, and coping mechanisms can help us in better understanding and comprehensive management of the illness. MethodsA cross-sectional comparative study was conducted at a tertiary care hospital. A total of 112 patients with ADS (test group) and 124 healthy age matched male controls were recruited from the same social milieu. They were assessed for hardiness, personality factors, and coping mechanisms using Hardiness scale, 16 Personality factors (5th Edition), and Brief COPE scale, respectively. The data were analyzed with Chi square, Student t tests (two tailed, unpaired), Mann Whitney U test, and Kruskal Waal analysis. ResultsThe test group had less hardy personality compared to control group (25% vs 43.54%) (p = 0.002). The level of Hardiness had an inverse relationship with alcohol dependence (p = 0.886). The majority of patients with ADS had high score on extraversion (p < 0.001), anxiety (p < 0.001), and tough-mindedness (p < 0.001), and the severity of alcohol dependence had an inverse relationship with extraversion (p = 0.004) and self-control (p = 0.002). The severity of ADS was directly related to the use of emotional support (p = 0.007) and substance use (p = 0.005) as coping mechanisms while the use of instrumental support (p = 0.001) and humor (p < 0.001) had inverse relationship with the severity of ADS. ConclusionsADS had less hardy personality and the level of hardiness had inverse relationship with alcohol dependence. The severity of alcohol dependence had an inverse relationship with extraversion and self-control. In terms of coping styles, substance use and use of emotional support was found to be directly related with the severity of alcohol dependence while the use of instrumental support and humor were found to be protective against severe dependence.

Study of Association of Severity of Alcohol Dependence with Quality of Sleep and Severity of Insomnia in Alcohol Dependence Syndrome Patients

Study of Association of Severity of Alcohol Dependence with Quality of Sleep and Severity of Insomnia in Alcohol Dependence Syndrome Patients

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

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

An explorative study comparing the burden of the caregivers of patients with mood disorders and alcohol dependence syndrome

ABSTRACT Background: Alcohol dependence syndrome (ADS) and mood disorders, such as bipolar disorder and depression, are psychiatric disorders punctuated by many relapses and remissions. Patients suffering from these disorders impose a considerable burden on their caregivers. The burden includes multiple responsibilities such as financial costs and physical care of the patient while compromising on their freedom. Due to their nature of relapses and chronicity, they also harm the caregiver’s mental health. Hence, our attempt to study and compare the caregiver burden imposed by mood disorders and ADS. Aims and Objectives: To study the burden between caregivers of patients with mood disorders and ADS and to identify a significant association, if any, between sociodemographic characteristics and caregiver burden. Methods: It is a cross-sectional hospital-based study. Sixty patients, along with their primary caregivers attending the psychiatry outpatient department at a teaching hospital, were included in the study. Detailed evaluation was done on patients and caregivers using a semi-structured pro forma. The Burden Assessment Schedule is a standardized tool that was used to assess the caregiver burden. Those with severe burden were then screened for psychiatric disorders using the Mini-International Neuropsychiatric Interview. Results: The burden was similar in caregivers of mood disorders and ADS patients. Only 17% of caregivers were found to have a clinically diagnosable psychiatric illness. Marital relation was more affected by alcohol dependence than mood disorder. Furthermore, caregivers of patients with ADS were more likely to develop psychiatric illnesses. A more significant burden was seen with increased duration of illness, though not significantly. Conclusion: The mean total burden score being similar in both groups implies that the degree of burden experienced is the same. Most caregivers reported symptoms of anxiety and depression, though not clinically significant.

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

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

Evaluation of spectrum of brain changes in alcohol dependence syndrome patients by magnetic resonance imaging

Background: Alcohol is socially and legally accepted substance of abuse ethanol intoxication may lead to loss of subcortical white matter, cerebral atrophy, Wernicke’ sencephalopathy, Marchiafava-Bignami disease etc. [1]Thus the main purpose of the study is to diagnose the alcohol-induced brain changes in Alcohol dependence syndrome patients and thus help in the planning of early treatment of the diagnosed condition, thereby preventing the further neurological decline.Aims1.To describe the various magnetic resonance imaging findings in alcohol dependence syndrome patients.2.To correlate the cortical changes to the number of years of drinking in alcohol dependence syndrome patients.Materials and Methods: The Study group consisted of 55 patients, who fulfilled the alcohol dependence syndrome criteria according to the International Classification of Disease criteria (ICD-10). Alcohol use disorder identification test scale was applied and individual with alcohol dependence score of >15 (for men) were considered for study. MRI brain protocol was used and MRI sequences were meticulously evaluated.Global cortical atrophy scale was used to qualitatively assess the cortical atrophy on FLAIR images. Scoring is given to each lobe separately after assessing the sulci and gyri appearance in each lobe.Results: Most common MRI brain finding was cerebral atrophy (40%) followed by cerebellar atrophy (21.8%), non specific T2 hyperintensities (14.5%) hepatic encephalopathy (5.4%), least common being central pontine myelinosis (1.8%) and marchiafava bignami disease (1.8%).Most common lobe to show changes of atrophy was frontal lobe, followed by parietal, temporal and least occipital lobe.Conclusions: MRI is the most sensitive imaging modality to identify various neuroimaging findings in alcohol dependence syndrome patients. Cortical atrophy findings were seen more in patients who were chronic drinkers with long duration history of alcohol intake alcohol intake of more than 20 years There was a significant association noted between duration of drinking and atrophic changes and the results were statistically significant (p

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Objective:Neuromodulatory interventions like transcranial direct current stimulation (tDCS) is an emerging and potential therapeutic strategy to help in reducing craving and relapse prevention in patients of alcohol dependence syndrome (1–4). The potential target for alcohol dependence is the dorsolateral pre-frontal cortex (dlPFC) as frontal dysfunction is a hallmark of alcoholism, even in alcohol dependence subjects with no major clinical and global cognitive deficits (5). In this context, this study was designed to explore the effect of tDCS treatment on craving and relapse prevention and its correlation to dorsolateral prefrontal cortex (DLPFC) activation in alcohol dependent patients.Methodology:This study was a double blinded randomized sham control trial, conducted at National Institute of Mental Health and Neurosciences, Bangalore after approval by the Institute Ethics Committee. Twenty-four patients of alcohol dependence syndrome were recruited after informed consent. After detoxification patients underwent baseline fMRI scans. Followed by tDCS with intensity of 2mA and duration of 20 minutes per day was administered for 5 consecutive days with cathode over left dorsolateral prefrontal cortex (DLPFC) and anode over right DLPFC. On the 5th day post fMRI scans were repeated. Both investigator and subjects remained blind throughout the study period. During scans patients were exposed to visual alcohol cues using VICE (visual image- Induced craving for ethanol) paradigm. Pre- treatment and post-treatment scans were analysed using SPM-12 software.Results:At the beginning of the study, 24 subjects were selected but 2 subjects dropped out before post fMRI scan. The baseline comparison of socio-demographic and clinical variables found to have no differences among both groups.fMRI results: At baseline, the true and sham tDCS groups had comparable BOLD activation patterns and there were no between-group differences in activation pattern noted for alcohol vs. neutral cues contrast. Following 5 sessions of tDCS, there is significantly increased activation observed in true tDCS group, from Pre- to Post- treatment scans. Brain activity at DLPFC (Post-Pre) was positively associated with time to first alcohol lapse (p=0.048, Spearman’s rho =0.426). This suggests that greater the increase in brain activity at DLPFC after treatment with bilateral repetitive tDCS longer was the time to first lapse. Conclusion:This study has shown bilateral repetitive transcranial direct current stimulation in alcohol dependent subjects, activates dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) along with increase in the connectivity strength between medial frontal gyrus (MFG) and sub cortical reward centre (NAc), which facilitated abstinence from alcohol. So from this study we better understood the mechanism of tDCS in preventing relapse to alcohol by activation of dorsolateral prefrontal cortex and anterior cingulated cortex. Though the fMRI results were statistically significant for relapse and DLPFC activation, but it would be difficult to establish the clinical significance of the improvement in craving in the background of small sample size. Hence further studies with larger sample size are required in near future. Referrences: 1. Klauss J, Penido Pinheiro LC, Silva Merlo BL, Correia Santos GDA, Fregni F, Nitsche MA, et al. A randomized controlled trial of targeted prefrontal cortex modulation with tDCS in patients with alcohol dependence. Int J Neuropsychopharmacol. 2014;17(11):1793–803.2. Boggio PS, Sultani N, Fecteau S, Merabet L, Mecca T, Pascual-Leone A, et al. Prefrontal cortex modulation using transcranial DC stimulation reduces alcohol craving: A double-blind, sham-controlled study. Drug Alcohol Depend. 2008;92(1–3):55–60.3. Nakamura-Palacios EM, Lopes IBC, Souza RA, Klauss J, Batista EK, Conti CL, et al. Ventral medial prefrontal cortex (vmPFC) as a target of the dorsolateral prefrontal modulation by transcranial direct current stimulation (tDCS) in drug addiction. J Neural Transm. 2016;123(10):1179–94.4. da Silva MC, Conti CL, Klauss J, Alves LG, do Nascimento Cavalcante HM, Fregni F, et al. Behavioral effects of transcranial Direct Current Stimulation (tDCS) induced dorsolateral prefrontal cortex plasticity in alcohol dependence. J Physiol. 2013;107(6):493–502.5. Nakamura-Palacios EM, Souza RSM, Zago-Gomes MP, de Melo AMF, Braga FS, Kubo TTA, et al. Gray Matter Volume in Left Rostral Middle Frontal and Left Cerebellar Cortices Predicts Frontal Executive Performance in Alcoholic Subjects. Alcohol Clin Exp Res [Internet]. 2014 Apr 1 ;38(4):1126–33. Available from: http://doi.wiley.com/10.1111/ acer.12308

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Background:Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty, which worsens the alcohol abuse. It may be due to the depressant effect of alcohol itself, alcohol-related disease or due to a multitude of psychological forces related to the alcohol use. There was a need to look at sexual dysfunction as per the severity of alcohol dependence.Aim:To study the sexual dysfunction in male patients of Alcohol Dependence Syndrome in age group 18-50 years.Methods:After institution of ethical approval and due consent, a cross sectional study was conducted among 85 Male inpatients of Alcohol Dependence Syndrome from Oct 2019 to Apr 2021 after meeting the inclusion and exclusion criteria. A specially designed data collection proforma and rating scales (SADQ, BFSI, IISF, IPE) were administered. Data thus generated was statistically analysed and compared with relevant literature in this direction.Results:Our study found that the sexual drive and sexual desire function domains had the strongest association with severity of alcohol dependence (p-value < 0.05). In addition, the erection function and overall intercourse satisfaction function also were associated with severity of alcohol dependence.Conclusions:Alcohol Consumption has a detrimental effect on sexual functioning with severity of alcohol dependence. The domains of sexual drive, sexual desire, erection and intercourse satisfaction are negatively affected to significant levels.

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Background:Course of Alcohol Dependence Syndrome (ADS) is studded with multiple relapses. Personality factors are implicated as one of the influencing factors in the course of this disorder. Keeping in view of scarcity of Indian data available, the study was planned with the aim to find Personality traits more commonly associated with ADS patients, and identify specific traits, associated with relapses of ADS.Method:Adult participants with alcohol dependence were recruited from the inpatient and outpatient wards for de-addiction in a tertiary care facility in India using a prospective design and followed up after 6 months. Questionnaires administered were revised NEO personality inventory (NEO-PI-R) (Costa and McCrae), Alcohol Use Disorder Identification Test (AUDIT) and Severity of Alcohol Use Disorder Test (SAD-Q) . With sample size of 113 consecutive cases, socio-demographic data was collected and further compared for differences in the dimensions in each of its subscale.Results:The NEO scores, showed statistically significant difference with Cases having higher scores in Neuroticism (64.6%). Neuroticism linked to higher scores of AUDIT and SADQ and also associated with relapses. Other traits also showed statistically significant association which are discussed.Conclusion:As new factors are being explored for effective management, routine personality profiling is easily accomplished and can give delightful insight into focused and designed management plan

Personality traits associated with Alcohol Dependence Syndrome and its relapse

BackgroundCourse of Alcohol Dependence Syndrome (ADS) is studded with multiple relapses. Personality factors are implicated as one of the influencing factors in the course of this disorder. Keeping in view of scarcity of Indian data available, the study was planned with the aim to find Personality traits more commonly associated with ADS patients, and identify specific traits, associated with relapses of ADS. MethodWith sample size of 100 consecutive cases and 100 controls, socio-demographic data was collected. Alcohol Use Disorder Identification Test (AUDIT) and Severity of Alcohol Use Disorder Test (SAD-Q) were administered to each of these patient. Personality dimensions were assessed with NEO-five factor inventory (NEO-FFI) (Costa and McCrae), for both groups and further compared for differences in the dimensions in each of its subscale. ResultsThe NEO scores, showed statistically significant difference with Cases having higher scores in Neuroticism and control group in Openness and Conscientiousness. Neuroticism linked to higher scores of AUDIT and SADQ and also associated with relapses. Other traits also showed statistically significant association which are discussed. ConclusionAs new factors are being explored for effective management, routine personality profiling is easily accomplished and can give delightful insight into focused and designed management plan.

Visual function and psychological variables in alcohol dependency syndrome

ABSTRACT Introduction: Alcohol Dependence Syndrome (ADS) is defined as excessive alcohol consumption accompanied by psychological, physical, social, and economic disorders. Alcohol consumption affects motor and proprioceptive functions, decreasing motor and cognitive functions and causing attention deficits. We aim to evaluate visual function and attention, and psychological profiles in consumer and abstainer ADS patients.Methods: This quantitative, descriptive, cross-sectional and correlational study evaluates visual function in a sample of ADS patients. The Portuguese version of the Brief Symptom Inventory was used to assess patients’ psychological status. The orthoptic examination protocol for visual function consisted of 11 standardized tests: VA for distance and near, ocular movements, near convergence and accommodation point, cover and prismatic cover tests, fusional vergence for distance and near, near stereoacuity, chromatic vision, contrast sensitivity and visual attention.Results: The sample included 176 patients. 121 were consumers and 55 were abstainers, aged between 31 and 72. The most affected parameters of visual function were visual acuity (80.39%), contrast sensitivity (67.50%), convergence at distance (66.44%) and near stereopsis (62.75%). Visual function was impacted in both groups. Regarding psychological status, consumers had higher averages for the Depression subscale, followed by Paranoid Ideation and Obsession. Abstainers had the highest averages in the Obsession subscale, followed by Paranoid Ideation and Depression. Statistically significant differences existed between the groups in the subscales for depression (p=.046) and paranoid ideation (p =.042).Conclusion: Changes in visual function and attention, as well as psychopathological function, should be considered in the rehabilitation of ADS patients.

Blood pressure profile in freshly detected alcohol dependence syndrome patients

Background: Alcohol consumption and raised Blood pressure (BP) are among the top five risk factors responsible for the growing global non-communicable diseases (NCD) burden. The present study was undertaken to study the relation between alcohol dependence syndrome (ADS) and hypertension and the effect of reduction in alcohol consumption on BP.Methods: A prospective observational study was conducted at a tertiary care hospital over a period of 02 years from 08 Oct 2016 to 02 Oct 2018. A total of fifty freshly diagnosed ADS patients with BP in the pre- hypertensive or hypertensive range after the withdrawal subsided, were recruited into the study. The study group was subjected to repeated BP measurements, serum Gamma glutamyl transferase (GGT) measurements and status of alcohol consumption at 03, 06, 09 and 12 monthly intervals. The data was analyzed with ANOVA, Post-hoc Bonferroni and Pearson’s correlation tests.Results: There was a statistically significant mean decrease in systolic and diastolic blood pressure from the baseline till 03 months and between 03 months and 06 months of follow-up. The correlation between GGT levels and systolic and diastolic BP at different time intervals showed that there was a statistically non-significant weak positive correlation at baseline (r value=0.125) (p value= 0.38). During follow-up period there was a negative correlation between GGT and systolic BP at 12 months (r value= -0.40), which was statistically significant. The correlation between alcohol consumption and BP at different time intervals showed a moderate positive correlation at baseline with systolic BP(r value= 0.478), which was statistically significant.Conclusions: This study evaluated changes in blood pressure occurring during Alcohol dependence syndrome treatment. Observed decreases in systolic and diastolic blood pressure were substantially accounted for by reductions in alcohol consumption and occurred largely in the first 03 months of treatment. There was no significant fall in systolic blood pressure between 06 months and 01-year duration of follow-up.

Electrophysiological Detection of Asymptomatic Neuropathy in Alcohol Dependence Syndrome Patients- A Cross Sectional Observational Study

Aim: To detect the prevalence of asymptomatic neuropathy using nerve conduction study among alcohol dependence syndrome patients and to investigate the existence or not of correlation between duration, quantity of alcohol consumption and neuropathy.&#x0D; Study Design: Observational cross-sectional study.&#x0D; Place and Duration of Study: Department of General Medicine and Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Pondicherry, affiliated to Sri Balaji Vidyapeeth (Deemed to be) University, India between February 2019 and August 2020.&#x0D; Methods: Alcohol dependence syndrome patients, asymptomatic for neuropathy were prospectively included and, patients who were symptomatic and had other comorbid conditions that can cause neuropathy were excluded. Patients were then submitted to nerve conduction studies. In patients who had neuropathy, duration and quantity of alcohol consumption were compared for correlation.&#x0D; Results: This study included 65 male patients who were mostly middle aged heavy drinkers of alcohol. 73.8% (n=48) had neuropathy. Our research showed longer the duration, larger the quantity of alcohol consumption, and higher the Cut-Annoyed-Guilty-Eye (CAGE score), more were the prevalence of neuropathy. This research also used Severity Of Alcohol Dependence Questionnaire (SAD-Q) scoring for screening alcohol dependence which showed patients with neuropathy were moderate drinkers. We did not find correlation with age of patients and neuropathy.&#x0D; Conclusion: This research results like correlation of prevalence of neuropathy and duration of alcohol consumption and quantity of alcohol consumption were in contrast with previous studies on alcoholic neuropathy. This research used SAD-Q scoring for dependence, future researches can throw light on usage of SAD-Q score in asymptomatic neuropathy and the correlation of neuropathy with alcohol consumption.

Condition of the tongue, periodontal and immune statuses in men with alcohol dependence syndrome

Relevance. Oral health problems, particularly periodontal diseases, are frequent complications in people with alcohol dependence syndrome (ADS). The assessment of the periodontal, immune status and the tongue condition in ADS patients by the set of indices is promising. Materials and methods. The periodontal and immune status and the tongue condition were examined in 114 men, of whom 47 were patients with stage II ADS and 67 were subjects without a history of ADS. Pearson's chi-squared test, Mann–Whitney U test, logistic regression, factor analysis were used for statistical analysis. Results. ADS patients have significantly worse oral hygiene (p &lt; 0.001) and 35.5 times higher probability of moderate to severe gum inflammation (p &lt; 0.001). Sextants with bleeding (39.0%) and calculus (25.9%) prevailed among ADS patients whereas most of sextants were healthy (85.8%) in the comparison group. Significant inter-group differences were found for all CPI codes except code 4 (p &lt; 0.001). The dorsal surface tongue coating (63.8%) and minor hyperkeratosis (27.7%) prevailed among ADS patients, while in the comparison group, there were no changes in 34.3% of subjects and coating was present in 38.8% (p = 0.003). The risk of satisfactory to poor oral hygiene was 3.7 times (p = 0.007) higher and the risk of moderate to severe gum inflammation was predicted to be 6.5 times (p = 0.015) higher if the examined subjects had changes in the tongue mucosa. The obtained differences in the level of IgG, TNF-α and cortisol prevailed in ADS patients (p &lt; 0.001). Conclusion. In ADS patients, the severity of periodontal diseases, changes in the tongue mucosa and mucosal immunity imbalance are statistically significant. The considered dental markers of chronic alcohol intoxication are proposed to be used at the treatment and checkup dental visits to screen individuals at risk of alcohol use disorder.

A comparative study of facial emotion recognition pattern and its determinants in patients of alcohol dependence syndrome versus matching controls

Background: Facial emotional recognition plays a pivotal role in human interactions and behavior. Long-term alcohol use leads to brain dysfunction that causes impairment in social cognitive abilities including facial emotional recognition. Objectives: Our study was aimed to assess the facial emotional recognition pattern in patients with alcohol dependence syndrome (ADS) and compared with that of matching controls and to study the sociodemographic and clinical correlates of facial emotional recognition in ADS. Setting and Design: This cross-sectional study was conducted at a tertiary care teaching hospital for a period of 1½ years. Fifty participants having ADS and fifty controls were included in the study. Materials and Methods: Fifty participants having ADS and fifty controls were included in the study. In the group with ADS, a semi-structured pro forma was used to collect the sociodemographic and clinical profile. Rating scales such as Severity of Alcohol Dependence Questionnaire, the Clinical Institute Withdrawal Assessment for Alcohol scale-revised, and facial emotion recognition test (FERT) were administered. For the control group, FERT was administered after collecting the data regarding sociodemographic profile and clinical variables. Results: It was observed a significant impairment in FERT scores in individuals having ADS (mean score = 19.93 ± 7.67) when compared to the control population (mean score = 32.73 ± 4.96T-test = −10.86; P < 0.001). Lower scores on FERT were observed in persons with severe alcohol dependence (one-way ANOVA = 41.79, P < 0.001). Post hoc Tukey testing showed the difference between groups having moderate-to-severe dependence (P < 0.001) and mild-to-severe dependence (P < 0.001). Conclusions: Significant impairment in facial emotional recognition skills were observed in patients having ADS. The subjects in ADS group were able to identify happy and angry emotions better while facing difficulties in identifying sad and fear full stimulus.

A cross-sectional study of prevalence and types of sexual dysfunction among married male patients with alcohol dependence syndrome attending tertiary healthcare center from Central Rural India.

BACKGROUND:Chronic and persistent alcohol use is one of the most common significant psychiatric illnesses known to cause sexual dysfunction. The aim of the present study is to study the prevalence and types of sexual dysfunction in the clinical sample of married male patients with alcohol dependence syndrome (ADS).MATERIALS AND METHODS:The present cross-sectional study was conducted in a tertiary healthcare center from Central Rural India over an 18-month period (from November 1, 2017, to April 30, 2019), with a sample size of 100 patients with diagnosis of ADS. Data were collected using convenient sampling method from married male patients diagnosed with ADS, based on the International Classification of Mental and Behavioral Disorders, 10th Edition–Diagnostic Criteria for Research. Sociodemographic profile and clinical variables were recorded in a specific case report form prepared for the study using the severity of alcohol dependence questionnaire (SADQ) to assess the severity of ADS and using Arizona sexual experiences scale (ASEX) to assess the types and prevalence of sexual dysfunction among patients with ADS. Data were collected and analyzed using SPSS Software Version 15.0, Chi-square test, and Pearson's test of correlation.RESULTS:Of the 100 patients of ADS assessed, 48% had sexual dysfunction. Majority of the patients reported more than one sexual dysfunction with 87.5% of the patients reporting reduced sexual drive, 79.1% of the patients reported dysfunction in sexual arousal, while erectile dysfunction was found in 58% of the patients. 54% of the patients reported difficulty in reaching orgasm. The lowest prevalence in our study was of orgasmic satisfaction reported by 31.2% of the patients. There was high positive correlation between SADQ scores and ASEX scores. Thus, as the severity of ADS increased, the risk of development of sexual dysfunctions also increased. Further, there was comparatively low but positive correlation between duration of ADS and sexual dysfunction on ASEX scores, indicating that as the duration of ADS increased, the risk of occurrence of sexual dysfunctions also increased.CONCLUSION:Chronic and severe alcohol dependence increases the chances of developing sexual dysfunctions. These findings can be utilized in the motivation enhancement therapy of patients with ADS to quit alcohol consumption and to improve their quality of sexual life.