Diagnosis Of Alcoholism Research Articles

Maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia: a population cohort record linkage study

ObjectivesExamine the relationship between maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia.DesignPopulation cohort study.SettingRoutinely collected linked administrative health, education and child...

Short stay vs long stay postpartum psychiatric admissions: a population-based study.

About 1-2/1000 of postpartum women require psychiatric admission. Length of stay is variable, and little is known about short postpartum admission. From all women in Ontario, Canada, with a psychiatric admission within 1year postpartum (2007-2012) (n=1702), we compared women with admissions <72h to women with longer admissions on sociodemographics, clinical characteristics and post-discharge mental health service use. About 37% of admissions were <72h. These women were more likely to be adolescents (11.7 vs 7.3%), less likely to be employed (16.6 vs 25.9%) compared to women with longer admissions, and fewer had a prior history of psychiatric admission (16.7 vs 59.0%). Index diagnoses of alcohol or substance use (12.5 vs 7.8%) and adjustment disorders (15.8 vs 6.3%) were more common in the short vs longer stay group; psychotic (5.8 vs 19.5%) and bipolar disorders (2.1 vs 14.2%) were less common. Women with short admission were at higher crude risk for ED revisit 7days post-discharge (11.4 vs 4.9% OR2.52, 95% CI1.74-3.66) and at lower adjusted risk for readmission at 365days post-discharge (19.5 vs 28.8%, aOR 0.63, 95% CI 0.46-0.85). Women with short stay postpartum admissions are a clinically distinct group that may benefit from targeted intervention.

The role of novelty seeking as a predictor of substance use disorder outcomes in early adulthood.

There has been a great deal of evidence showing that high novelty seeking (NS) is a risk factor for the development of substance use disorders (SUDs). However, the possible causal role of NS in SUDs is unconfirmed. The aim of this study was to examine the associations between NS at age 16 and SUDs from ages 18 to 35years, net of a series of covariate factors. Longitudinal study of a birth cohort. Christchurch, New Zealand. General community sample with sample sizes ranging from n=1011 (age 21) to n=962 (age 35). The Composite International Diagnostic Interview was used to derive DSM-IV diagnoses of alcohol, nicotine, cannabis and other illicit SUDs at four time intervals from ages 18 to 35. NS was measured at age 16 using the Tridimensional Personality Questionnaire. An increase in NS was associated with increases in the prevalence of all four SUDs at age 18-35. Following adjustment for a broad range of covariate factors, estimated effect sizes (odds ratios) were reducing in magnitude, but remained moderate to large. Adjusted odds ratios of SUDs for the highest NS quartile compared to with the lowest were 2.0 [95% confidence interval (CI)=1.5, 2.7] for alcohol; 1.8 (95% CI=1.3, 2.7) for nicotine; 3.6 (95% CI=2.4, 5.6) for cannabis and 5.1 (95% CI=2.9, 9.2) for other illicit substances. The association between high novelty seeking and substance use disorders is not explained by common underlying individual factors and environmental exposures. This is consistent with the view that novelty seeking may play a causal role in the development of substance use disorders.

Maternal alcohol disorders and school achievement: a population cohort record linkage study in Western Australia

ObjectiveMaternal alcohol use disorder is a risk factor for a range of developmental outcomes in children. This study examines school achievement in children of Indigenous and non-Indigenous mothers with an...

Genetic variation in the exome: Associations with alcohol and tobacco co-use.

Shared genetic factors represent one underlying mechanism thought to contribute to high rates of alcohol and tobacco co-use and dependence. Common variants identified by molecular genetic studies tend to confer only small disease risk, and rare protein-coding variants are posited to contribute to disease risk, as well. However, given that genotyping technologies allowing for their inclusion in association studies have only recently become available, the magnitude of their contribution is poorly understood. The current study examined genetic variation in protein-coding regions (i.e., the exome) for associations with measures of lifetime alcohol and tobacco co-use. Participants from the UCSF Family Alcoholism Study (N = 1,862) were genotyped using an exome-focused genotyping array, and assessed for DSM-IV diagnoses of alcohol and tobacco dependence and quantitative consumption measures using a modified version of the Semi-Structured Assessment for the Genetics of Alcoholism. Analyses included single variant, gene-based, and pathway-based tests of association. One EMR3 variant and a pathway related to genes upregulated in mesenchymal stem cells during the late phase of adipogenesis met criteria for statistical significance. Suggestive associations were consistent with previous findings from studies of substance use and dependence, including variants in the CHRNA5-CHRNA3-CHRNB4 gene cluster with cigarettes smoked per day. Further, several variants and genes demonstrated suggestive association across phenotypes, suggesting that shared genetic factors may underlie risk for increased levels of alcohol and tobacco use, as well as psychopathology more broadly, providing insight into our understanding of the genetic architecture underlying these traits. (PsycINFO Database Record

Evaluating Prediction Performance of Link Functions in Diagnosis Models for Alcohol Addiction

Since diagnosis of alcohol addiction is largely questionnaire-based, the information communication technology (ICT)-driven advancement of big data application enables development of mathematical models for more effective diagnosis of addiction. This study presents a prototype diagnostic mathematical model for an interdisciplinary alcohol addiction diagnostic system under construction. Survey data acquired from 253 subjects using the Korean alcohol addiction test developed by the Korean National Mental Health Center was utilized to develop a mathematical model based on ordinal logistic analysis which defines the degree of alcohol addiction as probability. Because the type of link function determines the model’s accuracy, five types of link functions such as logit function, cauchit function, complementary log-log function, negative log-log function, and probit function were used to develop five types of diagnostic mathematical models. These models were then assessed for accuracy using prediction accuracy, probability of detection, and false alarm rate tests to select an optimal model for alcohol addiction diagnosis. Our study shows the resistance distribution of alcoholism is similar to the Gumbel distribution, and a model which uses the complementary log-log function is the most suitable one for the diagnosis of alcoholism.

Educating Emergency Department Registered Nurses (EDRNs) in screening, brief intervention, and referral to treatment (SBIRT): Changes in attitudes and knowledge over time

Alcohol and other drug (AOD) diagnoses in the ED co-occur with injury-related presenting conditions including: falls, motor vehicle accidents, poisonings, and both intentional and unintentional injuries. Clinical attention to ED admissions resulting from hazardous AOD use can significantly improve patient care and reduce high cost utilization of ED visits and treatment. The EDRN-SBIRT project is designed to improve the knowledge and attitudes of ED nurses working in a large academic medical center to identify and address risky AOD use as it relates to an ED visit. ED nurses’ knowledge and attitudes toward patients with AOD use can be improved through SBIRT education. SBIRT education can establish an evidence-based standard of nursing practice to improve healthcare outcomes, but it must be reinforced with ongoing ED review and supportive educational sessions until practice is firmly established.

Social outcomes associated with alcohol-related diagnoses: a population-based analysis using linked administrative data

ABSTRACT&#x0D; ObjectiveThe objective of this population health research is to identify the social burden associated with having an alcohol related diagnosis.&#x0D; MethodsWe used linkable population-based administrative data files held in the Population Health Research Data Repository to conduct our research, fiscal years 1990/91 to 2014/15. Data came from several domains including health, social services, justice, and the Canadian Census. We used ICD-9/10-CA codes from the hospital abstract database, medical claims data, and prescription drug data to identify individuals with an alcohol-related diagnosis. Individuals’ socioeconomic status was determined using neighbourhood-level income data from the Canadian Census. We matched, 3:1, diagnosed cases to individuals in our repository using on age, sex, income, and community area. We linked cases and matches to administrative data from justice and social services to identify social outcomes associated with having an alcohol-related diagnosis. Outcomes included receipt of income assistance, residence in publically funded social housing, having a child apprehended by child and family protective services, having a charge for driving under the influence recorded in the justice data, and having a charge for domestic violence recorded in the justice data. We modelled rates using generalized estimating equations from 5 years before date of diagnosis to a maximum of 20 years after date of diagnosis. Models tested for significant differences in rates between cases and matches both before and after diagnosis; as well, we tested for time trends in rates both before and after diagnosis.&#x0D; ResultsWe identified 52,991 individuals with an alcohol related diagnosis between 1990/91 and 2014/15: 34,145 males and 18,846 females. 80.3% of cases had a mental-health related alcohol diagnosis. Diagnoses followed a socioeconomic gradient with the greatest number of cases coming from low-income neighbourhoods. Cases had a significant spike in rates from one year before to one year after diagnosis date, compared with matches, across all indicators. When we followed individuals for 20 years after diagnosis, we found a significantly elevated rate of social service use and involvement with the justice system, across all outcomes, for all years.&#x0D; ConclusionReceiving an alcohol-related diagnosis is associated with subsequent increased use of social services and contacts with the justice system. Upstream efforts to reduce alcohol-related diagnoses may result in reduced use of social services and justice contacts.

Effect of clozapine on psychiatric comorbidities in patients with schizophrenia

IntroductionClozapine has superior efficacy in treatment-resistant schizophrenia, and has various effects on psychiatric comorbidities, which may affect the illness course.AimsWe aimed to assess the past and current psychiatric comorbidities in schizophrenia patients treated with clozapine, and study their relationship with clinical variables.MethodsConsecutive 122 outpatients who met DSM-IV criteria for schizophrenia receiving clozapine were included. Information about past and current clinical status were gathered through a clinical interview and review of the medical records, along with laboratory test results. Patients were assessed with structured clinical interview for Axis-I Disorders for DSM-IV, Clinical Global Impression Scale, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Panic and Agoraphobia Scale (PAS), WHO-Disability Assessment Schedule-II.ResultsThere was a significant decrease in the diagnosis of depression, alcohol and substance use disorder, number of suicide attempts, and an increase in the diagnosis of obsessive compulsive disorder (OCD) after clozapine initiation. Clozapine related de novo OCD appeared in 48.4% of the patients, and there was a positive correlation between Y-BOCS total scores and clozapine dose and plasma levels. In the de novo OCD group, compulsion scores were higher than obsession scores with checking most prevalent among compulsions. Total PANSS, Y-BOCS, PASscores were positively correlated withtotal disability score.ConclusionsClozapine seems to decrease comorbid depression, alcohol and substance use and number of suicide attempts and increase OCD. Assessment and treatment of psychiatric comorbidities in clozapine using schizophrenia patients is vital to decrease disability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Substance use disorders and the risk of suicide mortality among men and women in the US Veterans Health Administration.

Limited information is available regarding links between specific substance use disorders (SUDs) and suicide mortality; however, the preliminary evidence that is available suggests that suicide risk associated with SUDs may differ for men and women. This study aimed to estimate associations between SUDs and suicide for men and women receiving Veterans Health Administration (VHA) care. A cohort study using national administrative health records. National VHA system, USA. All VHA users in fiscal year (FY) 2005 who were alive at the beginning of FY 2006 (n=4 863 086). The primary outcome of suicide mortality was assessed via FY 2006-2011 National Death Index (NDI) records. Current SUD diagnoses were the primary predictors of interest, and were assessed via FY 2004-2005 VHA National Patient Care Database (NPCD) records. In unadjusted analyses, a diagnosis of any current SUD and the specific current diagnoses of alcohol, cocaine, cannabis, opioid, amphetamine and sedative use disorders were all associated significantly with increased risk of suicide for both males and females [hazard ratios (HRs)] ranging from 1.35 for cocaine use disorder to 4.74 for sedative use disorder for men, and 3.89 for cannabis use disorder to 11.36 for sedative use disorder for women]. Further, the HR estimates for the relations between any SUD, alcohol, cocaine and opioid use disorders and suicide were significantly stronger for women than men (P<0.05). After adjustment for other factors, most notably comorbid psychiatric diagnoses, associations linking SUDs with suicide were attenuated markedly and the greater suicide risk among females was observed for only any SUD and opioid use disorder (P<0.05). Current substance use disorders (SUDs) signal increased suicide risk, especially among women, and may be important markers to consider including in suicide risk assessment strategies. None the less, other co-occurring psychiatric disorders may partially explain associations between SUDs and suicide, as well as the observed excess suicide risk associated with SUDs among women.

Personal theories of substance use among middle-aged and older adults with bipolar disorder

ABSTRACTObjectives: Most persons with bipolar disorder (BD) misuse alcohol and/or illicit drugs at some point, yet research specific to older adults with BD is nascent. The current study sought an in-depth understanding of the experiences and meanings of substance use in a sample of adults who self-reported substance misuse.Methods: Semi-structured interviews were conducted and thematically analyzed to understand the personal theories of substance use by 12 adults (9 women and 3 men; M = 49 years old) who self-reported diagnoses of BD and regular alcohol or illicit drug use.Results: Findings provide an in-depth picture of the theories middle-aged and older adults with BD have developed to explain their substance use. Participants’ theories suggest multiple reasons for substance use, including self-medication; increased confidence with substance use; rejection of prescribed medications; easy access to alcohol; early social exposure/use as facilitator; and living in a culture of substance use.Conclusion: Findings suggest multiple theories for the comorbid link between BD and substance use, primarily that persons with BD use drugs and/or alcohol to relieve stress or manage symptoms. It is clinically relevant to incorporate personal reasons for actively and regularly using substances as part of personalized substance treatment and BD symptom management.

The effects of alcoholism and smoking on advanced cancer patients admitted to an acute supportive/palliative care unit.

The aim of this prospective study was to determine the characteristics and symptom burden of advanced cancer patients with alcoholism problems and smoking, who were referred to an acute palliative/supportive care unit (ASPCU) of a comprehensive cancer center. Patients' characteristics, indications for admission, kind of admission, awareness of prognosis, and anticancer treatments were recorded. The Edmonton Symptom Assessment Scale (ESAS) was used to assess physical and psychological symptoms, and the CAGE questionnaire for the diagnosis of alcoholism. Patients were also divided in three groups: persistent smokers (PS), former smokers (FS), and non-smokers (NS). The Memorial Delirium Assessment Scale (MDAS) was used to assess the cognitive status of patients. Analgesic drugs and their doses at admission and discharge were recorded, as well opioid escalation index during hospital stay. Three hundred fourteen consecutive cancer patients were surveyed. Forty-seven (14.9%), 143 (45.5%), and 124 (39.5%) subjects were PS-patients, FS-patients, and NS-patients, respectively. Sixteen patients were CAGE-positive. Females were more frequently NS, while males were more frequently FS (p=0.0005). Statistical differences were also observed in disease awareness among the categories of smoking (p=0.048). No statistical differences were found in ESAS items, except for drowsiness at T0 in NS-patients. Differences were found in OME and OEI, although the large variability of data did not determined a statistical difference. Higher values of nausea (at T0, p=0.0005), dyspnea (at T0 and TX, p=0.08 and 0.023, respectively), and well-being (at TX p=0.003) were reported in CAGE-positive patients. No correlation was found between CAGE-positive patients and smokers. Although smoking and alcoholism have obvious implications in advanced cancer patients, data remain controversial, as present data did provide limited data to confirm risk factors for advanced cancer patients. Clinical response was not strongly influenced by these risk factors.

Use of routinely collected Hospital Episode Statistics to describe alcohol-related frequent attenders to hospitals

BackgroundExcess alcohol consumption is a growing public health problem, causing 5·3% of deaths worldwide in those aged under 60 years. In the UK, alcohol use costs the National Health Service (NHS) £3·5 billion annually, 80% of which is used for hospital-based care. Alcohol-related hospital admissions have doubled in the past 8 years in England. With no universal way of identifying hospital admissions of alcohol-related frequent attenders (ARFAs), the true burden on the NHS is unknown including use of accident and emergency services, costs of inpatient admissions, and long-term health and social care. We aimed to identify characteristics of ARFAs to investigate whether they differ from other hospital service users and to better understand the complexity of this group. MethodsUsing pseudonymised Hospital Episode Statistics data from the Secondary Uses Service, ARFAs (more than three admissions per year, including at least one wholly attributable alcohol diagnosis in any diagnostic field) were identified from all admissions to south London hospitals between April 1, 2013, and March 31, 2014. Comorbidities, age, sex, and income deprivation for ARFAs were compared with those of all other admitted patients. Findings1897 ARFAs were identified from a total of 366 616 people admitted (5198 [0·7%] of 740 818 admissions). ARFAs were more likely than other admitted patients to be male (72·4% [1373/1897] vs 37·9% [124 919/329 218], p<0·0001), to be income deprived (Index of Multiple Deprivation 04 score 28·04, p<0·0001), and to have comorbidities (22% [417/1897] vs 8% [28 737/364 719]). ARFAs were also more likely to be older than other attenders (mean age ARFAs 55·4 years [SD 15·1] vs alcohol-related non-frequent attenders 50·0 [16·2], p<0·0001, and non-alcohol-related non-frequent attenders 51·6 [20·3], p<0·0001) but younger than non-alcohol-related frequent attenders (55·4 [15·1] vs 56·9 [21·1], p=0·01). Relative risk of comorbidity for ARFAs versus all other patients was 9·35 for self-harm (p<0·0001), 3·29 for assault (p<0·0001), 2·04 for diabetes mellitus (p<0·0001), 1·73 for circulatory disease (p<0·0001), 1·58 for cancer attributable to alcohol (p=0·0292), and 1·45 for mental health (p<0·0001). InterpretationARFAs have distinct characteristics that differentiate them from other patient groups: preliminary analysis shows that ARFAs tend to be older, male, experiencing income deprivation, and more likely to have comorbidities. An understanding of the characteristics of ARFAs and their health service use might help target preventive interventions to this group, reducing harms before high costs for the NHS are accrued. FundingInnovation fellowship supported by the Health Innovation Network (Academic Health Science Network for South London). This research is partly funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research.

Discovery and identification of potential biomarkers for alcohol-induced oxidative stress based on cellular metabolomics.

Biomarkers involved in alcohol-induced oxidative stress play an important role in alcoholic liver disease prevention and diagnosis. Alcohol-induced oxidative stress in human liver L-02 cells was used to discover the potential biomarkers. Metabolites from L-02 cells induced by alcohol were measured by high-performance liquid chromatography and mass spectrometry. Fourteen metabolites that allowed discrimination between control and model groups were discovered by multivariate statistical data analysis (i.e. principal components analysis, orthogonal partial least-squares discriminate analysis). Based on the retention time, UV spectrum and LC-MS findings of the samples and compared with the authentic standards, eight biomarkers involved in alcohol-induced oxidative stress, namely, malic acid, oxidized glutathione, γ-glutamyl-cysteinyl-glycine, adenosine triphosphate, phenylalanine, adenosine monophosphate, nitrotyrosine and tryptophan, were identified. These biomarkers offered important targets for disease diagnosis and other researches.

The Measurement of Adolescent Alcohol Problems via Item Response Theory and Their 15-Year Prospective Associations with Alcohol and Other Psychiatric Disorders.

A limited number of measures exist to assess alcohol problems during adolescence. Item response theory modeling was used to scale a measure of adolescent alcohol problems, including drinking and driving, and then related to alcohol and other psychiatric disorders that occurred over a 15-year period. High school students (N=832) completed the 13-item Alcohol Problems Index (API) at age 18years as part of a long-term longitudinal study of predictors of alcohol use and alcohol disorders. Frequency of drinking and driving was also measured during adolescence. Lifetime psychiatric disorders, including alcohol disorders, were measured during young adulthood. Rasch modeling was used to scale the severity of alcohol problems, and the scaled total score was used to prospectively predict alcohol disorders. The area under the receiver operating characteristic (ROC) curve was also computed between the adolescent alcohol problems and alcohol and other psychiatric disorders across a 15-year period. The prevalence of alcohol disorders was 38.7% (for alcohol dependence, it was 27.7%). Rasch modeling indicated that the API assessed a range of severity of alcohol problems and that drinking and driving were among the less severe indicators. Age 18 API scores significantly correlated with an alcohol diagnosis (0.34), and ROC curve analysis indicated that for adolescent alcohol problem scores, the diagnostic accuracy (or area under the curve) for an alcohol diagnosis by age 33 was 0.70. Our findings supported the unidimensionality and reliability of the API, and statistically significant prospective prediction of young adult alcohol disorders. The measurement of alcohol problems during adolescence, in addition to drinking and driving, may be beneficial in understanding adverse consequences of drinking during adolescence as well as transitions in alcohol use and alcohol disorders across the lifespan.

Retrospective Analysis of Sociodemographic Characteristics of Inpatients at Kayseri Research and Training Hospital AMATEM Clinic

Objective: The purpose of this study is to retrospectively determine the sociodemographic characteristics of inpatients with the diagnoses of alcohol and substance use disorder in AMATEM (Research, Treatment and Training Center for Alcohol and Substance Dependence) clinic of Kayseri Training and Research Hospital. Methods: Medical records of 1222 patients who were hospitalized at AMATEM clinic of Kayseri Training and Research Hospital between the years 2007-2015 were analyzed retrospectively and the obtained data were recorded on data sheets prepared by us. Statistical evaluation of the data was recorded in a database prepared by SPSS 23 software. Chi-square test was used for descriptive analyzes. The confidence level was taken as 95% and the statistical significance limit was accepted as p

Association between Body Mass Index and Quality of Life in Elderly People over 60 Years of Age.

BackgroundThe Korean population is aging rapidly and the number of health threats is increasing. The elderly obese population is also increasing and this study aimed to evaluate the association between body mass index (BMI) and health-related quality of life in the elderly Korean population.MethodsThe Korean version Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was administered to elderly subjects (≥60 years) selected from welfare and health centers, and university hospitals. Sociodemographic information and subjects' height and weight were also recorded.ResultsThe study population's mean age was 74.2±7.1 years, and the average BMI was 24.5±3.2 kg/m2. The 542 participants were segregated based on BMI quartiles. The SF-36 scores were compared among the sex-stratified quartile groups after adjusting for age, education level, income, smoking, alcohol, and arthritis diagnosis. The SF-36 scores were compared for four BMI quartiles stratified by sex, after adjusting for age, education level, income, smoking, alcohol consumption, and arthritis diagnosis. Men in the Q3 and Q4 groups had higher mental health scores than men in Q2 group. Additionally, men in the Q3 group had higher social function scores than those in the Q2 and Q4 groups. No differences were observed for the remaining six domains; no significant score differences were observed in any of the survey domains for the female subjects.ConclusionThere was no significant association between a high BMI and a low quality of life in the elderly Korean population selected from hospitals and welfare centers, as assessed using the SF-36 scores.

Aorto-oesophageal fistula secondary to impaction of a fish bone at autopsy

Aorto-oesophageal fistula is a life threatening condition in which there is an abnormal connection between the aorta and oesophagus, and is a rare complication of foreign body ingestion from which few patients survive. Classic presentation is with Chiari’s triad of mid thoracic pain, sentinel arterial haemorrhage and massive exsanguination after a symptom free interval. A 36-year-old male was transferred to a tertiary care hospital with a history of epigastric pain and discomfort in his retro-sternal area. According to the history, he had ingested fish the previous day while consuming alcohol. He was treated for four days in the hospital, and discharged with a diagnosis of alcohol induced gastritis. He was re-admitted later the same day with an episode of haematemesis. However, investigations such as chest radiography and oesophagogastroduodenoscopy were not carried out. He developed massive haematemesis 12 hours later, and despite vigorous resuscitation and emergency surgery, he expired. Autopsy revealed an impacted fish bone at the junction of upper and middle third of the oesophagus creating a fistula tract from oesophagus to thoracic aorta which resulted in exsanguination, haemorrhagic shock and death. Even though mortality is very high, survival is possible with a high index of suspicion, early diagnosis and rapid surgical intervention. Autopsy findings, review of the literature and medico-legal aspects of possible medical negligence are discussed.

Support for Relatives Bereaved by Psychiatric Patient Suicide: National Confidential Inquiry Into Suicide and Homicide Findings.

International suicide prevention strategies recommend providing support to families bereaved by suicide. The study objectives were to measure the proportion of cases in which psychiatric professionals contact next of kin after a patient's suicide and to investigate whether specific, potentially stigmatizing patient characteristics influence whether the family is contacted. Annual survey data from England and Wales (2003-2012) were used to identify 11,572 suicide cases among psychiatric patients. Multivariate regression analysis was used to describe the association between specific covariates (chosen on the basis of clinical judgment and the published literature) and the probability that psychiatric staff would contact bereaved relatives of the deceased. Relatives were not contacted after the death in 33% of cases. Contrary to the hypothesis, a violent method of suicide was independently associated with greater likelihood of contact with relatives (adjusted odds ratio=1.67). Four patient factors (forensic history, unemployment, and primary diagnosis of alcohol or drug dependence or misuse) were independently associated with less likelihood of contact with relatives. Patients' race-ethnicity and recent alcohol or drug misuse were not associated with contact with relatives. Four stigmatizing patient-related factors reduced the likelihood of contacting next of kin after patient suicide, suggesting inequitable access to support after a potentially traumatic bereavement. Given the association of suicide bereavement with suicide attempt, and the possibility of relatives' shared risk factors for suicide, British psychiatric services should provide more support to relatives after patient suicide.

Pontine Changes in Metabolites and Axonal Fibres of Rats Following Four-week Alcohol Exposure: In Vivo Diffusion Tensor Imaging and 1h-magnetic Resonance Spectroscopy Study at 7.0 T.

Aims We characterized the metabolite content and axonal fibre changes in the rat pontine, in vivo , using 1H-magnetic resonance spectroscopy (1H-MRS) and diffusion tensor imaging (DTI) with a 7.0 T magnetic resonance imaging (MRI) scanner following chronic alcohol administration to explore new indicators for the early diagnosis and treatment of chronic alcoholism. Methods Forty male Sprague-Dawley rats were randomly divided into the EtOH and control groups (water group). To establish a chronic alcohol administration rat model, rats were intragastrically administered edible wine (56% vol/vol) twice daily for four weeks. Quantitation of the changes in metabolite concentrations and the apparent diffusion coefficient (ADC), as well as the fractional anisotropy (FA) values, within the pontine of brain stem were detected using MRS and DTI at 7.0 T. Differences of the pontine metabolite content, ADC and FA values between the two groups were compared. Results The 7.0 T MRIs showed no abnormal T2 phase pontine signals in either the EtOH or control groups. A 1H-MRS scan showed that the values for NAA, Cr and Cho in the EtOH group (4.54 ± 0.69, 4.69 ± 0.70 and 1.32 ± 0.18) were lower than those in the controls (6.78 ± 0.76, 8.50 ± 0.83 and 1.89 ± 0.24) ( P 0.05). DTI showed that the FA value in chronic alcohol exposure rats (0.41 ± 0.12) was lower than the control rats (0.53 ± 0.08) ( P 0.05). Conclusions After chronic alcohol exposure for four weeks, the metabolite content and axonal fibre changes in the rat pontine can be detected using MRS and DTI at 7.0 T earlier than conventional MRI, which provides information for the early diagnosis and treatment of chronic alcoholism. Short Summary In the present study, the authors showed that the metabolite content and axonal fibre changes in the pontine of chronic ethanol-treated rats can be detected using MRS and DTI at 7.0 T earlier than conventional MRI, which provide objective indicators for the early diagnosis and treatment of chronic alcoholism.