CAGE Questionnaire Research Articles

Alcohol abuse and discretionary habits in psoriatic patients: impact on IL-17 and IL-23 inhibitor response.

Alcohol abuse is correlated with the onset and worsening of psoriasis, but its effects, as for smoking, on biological therapies are still poorly investigated. This study aimed to determine the prevalence of alcohol abuse and other discretionary habits (such as smoking and sedentary lifestyle) in patients with psoriasis treated with topicals, conventional systemic and biologic therapies. The second objective is to investigate the impact of discretionary habits, focusing on alcohol abuse, on the response to biological therapy. To identify alcohol dependence, the CAGE questionnaire was distributed among patients of our clinic. 305 patients were included with 18% at high risk of alcohol abuse. Clinically, guttate psoriasis and psoriatic arthritis were more common in patients at higher risk of alcohol abuse. Furthermore, patients with an alcohol problem who started biological therapy reported a higher PASI than those who drank less. None of the considered variables seemed to correlate with discontinuation of medication or with lower achievement of the analyzed outcomes (PASI100, PASI90, and PASI≤3). There was a stronger association between alcohol dependence and patients receiving conventional therapy than with patients receiving biologics. The efficacy of biologicals did not seem to be impacted by alcohol consumption, smoking, or sedentary lifestyle.

Prevalence and determinants of depression among patients attending adult HIV clinic of University of Uyo Teaching Hospital, Uyo, Southern Nigeria

Background: Mental health challenges particularly depression is common among people living with HIV/AIDS and has been largely neglected. This is of great concern because depression is associated with high morbidity among its sufferers. An assessment of depression among PLWHA and its predictors will enhance their quality of life and improve their health outcomes. Aim: To determine the prevalence and determinants of depression among patients attending the adult HIV clinic in University of Uyo Teaching Hospital, Uyo, Nigeria. Method: This was a cross-sectional descriptive study conducted at the adult HIV outpatient clinic of University of Uyo Teaching Hospital Uyo. A total of three hundred and fifty one eligible respondents were recruited over three months. Their levels of perceived social support, depression, HIV stigma and substance abuse were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), Patient Health Questionnaire 9 (PHQ 9), Internalized AIDS-related Stigma Scale and CAGE questionnaire respectively. Results: The mean age of the respondents was 39.8 ± 10.7 years. Two hundred and sixty six (75.8%) of the respondents were females, while eighty five (24.2%) were males. The overall prevalence of depression was 10%. Majority of respondents had disclosed their status and were experiencing HIV stigmatization representing 84.6% and 95.4% respectively. Most of the respondents (65.8%) had low perceived social support. Depression was found to be statistically associated with unskilled workers (χ2 = 13.08, p = 0.008), unmarried respondents (χ2 = 8.45, p = 0.03), low perceived social support (χ2 = 7.76, p = 0.02), shorter duration of ART use (χ2 = 8.41, p = 0.04), adverse life events (χ2 = 4.05, p = 0.04) and increasing levels of HIV stigma (χ2 = 7.66, p = 0.02) among the study participants. Conclusion: The findings of this study showed that the prevalence of depression in PLWHA was high. Therefore, the screening and prompt treatment of depression in HIV positive persons should be inculcated into their management plan. Furthermore, policies should be made to minimize discrimination and stigmatization of PLWHA in the communities and healthcare systems. Finally, the relevant stakeholders should work in unison to improve the social welfare conditions of HIV infected persons.

Assessment of personality factors amongst alcoholics and non-alcoholics in rural part of Central India: A cross-sectional study

Background Consuming alcohol has a significant negative impact on an individual’s mental, physical, and overall health in India. Recent data from the World Health Organization reveals that alcohol consumption is a leading cause of numerous fatalities. Some individuals may turn to alcohol as a way to cope with grief and anxiety; however, it diminishes the brain’s serotonin levels, potentially leading to suicidal thoughts and changes in personality. Consequently, there is an immediate need for health education and awareness campaigns addressing the consequences of alcohol use. This research aims to assess and compare the influence of personality factors on individuals who are alcohol-dependent and those who abstain from alcohol, exploring their role in the development of alcohol-related disorders in rural areas. Methods This in-hospital cross-sectional study is conducted among adults aged 18 to 65 in the rural region of central India. Employing a non-probability sampling method, specifically the Daniel Formula, a sample size of 180 was determined from the accessible population. The research has received approval from the ethics committee. In both the inpatient and outpatient departments of the Psychiatry unit at the hospital, individuals diagnosed with alcoholism and their non-alcoholic counterparts will be approached. Prior to providing socio-demographic information and completing questionnaires on the Alcohol Use Disorders Identification Test (AUDIT), CAGE Questionnaire, and Sixteen Personality Factor Questionnaire (16 PF), informed consent will be obtained from the participants. Expected outcome Upon obtaining responses to the aforementioned questionnaires, we will be able to analyze and determine the correlation of personality factors between individuals who are alcohol-dependent and those who abstain from alcohol.

Prevalence of alcohol use disorder in migrants from a Portuguese Center for Refugees: a study protocol

Introduction According to the 2023 statistical report from the Portuguese Migration Observatory, Portugal has received over 72,000 refugees since 2015, with a significant number (56,041) being displaced citizens from Ukraine. This influx includes spontaneous asylum requests. The major countries of origin for refugees in Portugal are Afghanistan, India, Gambia, Pakistan, and Morocco. Notably, refugee populations exhibit elevated incidence rates of specific psychiatric disorders, including post-traumatic stress disorder and depressive disorders. These conditions are independent risk factors for substance use disorders. Furthermore, refugees face unique risks related to their migration journey, increasing their vulnerability to substance use disorders. The prevalence of substance use disorders, especially Alcohol Use Disorder, can reach up to 36% in this population. CAR 1 (Reception Center for Refugees) is a vital social facility in Portugal dedicated to enhancing the reception and integration of asylum seekers and refugees.ObjectivesOur primary objective is to determine the prevalence of potential alcohol problems and unhealthy alcohol use within the Portuguese Refugee Center in Lisbon. Our secondary aim is to comprehensively characterize the migrant population. This includes gathering data regarding demographic information, legal status, country of origin, pre-migration alcohol-related issues, psychiatric diagnoses, history of psychiatric evaluations, self-initiated help-seeking behavior, and self-perceived alcohol-related problems.Methods All individuals currently residing in our refugee center (approximately 70 people) will be invited to participate in a comprehensive survey and screening process. Exclusion criteria will apply to individuals with acute psychiatric conditions unable to provide reliable responses. The survey includes the Alcohol Use Disorders Identification Test (AUDIT) and the CAGE questionnaire. Quantitative data obtained from the questionnaires will be analyzed using Microsoft Excel and IBM SPSS 29 software.ResultsWe anticipate a high prevalence of positive responses to the AUDIT due to potential alcohol-related issues but expect low responses to the CAGE questionnaire due to limited awareness of alcohol use disorder and a reduced perception of the need for help.ConclusionsThis study could help identify and validate the prevalence of alcohol use disorders among migrants, emphasizing the need for appropriate responses. By shedding light on these challenges, we hope to promote effective responses to alcohol use disorder and encourage the utilization of alcohol screening tests in refugee centers, emphasizing the importance of seeking consultation when needed.Disclosure of InterestNone Declared

Longitudinal effects of disaster-related experiences on problem drinking among Fukushima nuclear plant workers.

In the Fukushima nuclear power plant disaster of March 11, 2011, plant workers were exposed to various traumatic events and reported a subsequent increase in alcohol use. To determine the relationship between disaster-related experiences and problem drinking, we conducted a three-year follow-up study. Problem drinking among the nuclear plant workers was assessed annually from 2012-2014 using a modified version of the CAGE questionnaire that asked about current, rather than lifetime, drinking. A total of 1378 workers provided at least one CAGE response, and 2875 observations were used in the present analysis. Mixed-effects logistic regression models were used to analyze the relationship between disaster-related experiences and problem drinking over time. The prevalence of problem drinking (CAGE score ≥2) increased over time. At the baseline assessment in 2012, a year after the disaster, plant workers who had experienced life-threatening danger and discrimination had significantly more symptoms of problem drinking, which persisted over the following 2 years. Although at baseline, plant workers who had experienced major property loss or the death of a colleague showed no significant differences in problem drinking symptoms from those without such experiences, over the next 2 years their problem drinking increased significantly. Individuals who experienced life-threatening danger and discrimination during the Fukushima nuclear power plant disaster reported an increase in problem drinking. Although major property loss and the death of a colleague did not elevate problem drinking prevalence at baseline, it did so over the next 2 years. Different adverse effects of a natural disaster appear to differentially increase drinking behavior over time.

Non-alcoholic beverage consumption among US adults who consume alcohol.

Non-alcoholic beverages (NABs) that mimic alcohol without inducing intoxication, such as non-alcoholic beers, non-alcoholic wines and spirit-free drinks, are increasing in popularity. It is unknown whether NABs help to mitigate or stimulate alcohol use. The present study aimed to describe NAB consumption practices among US adults consuming alcohol, characterize who is likely to consume NABs and examine whether NAB use influences desire for and perceived consumption of alcohol. The survey study used data collected June-July 2023 from an on-line convenience sample. The first survey (n = 1906) assessed frequency of NAB consumption among US adults who consume alcohol. A second more detailed survey on use patterns was conducted with 466 respondents who reported past-year NAB consumption, of whom 153 (32.83%) screened positive on the CAGE questionnaire for alcohol use disorder (AUD). This study took place in the United States. NAB consumption measures included type of NAB consumed, frequency, quantity, first consumption age, consumption reasons, consumption contexts and perceived effect on desire for and consumption of alcohol. Alcohol use measures included frequency, quantity and first consumption age. Past-year NAB use was endorsed by 28.44% of respondents (61.70% ever used). Non-alcoholic liquor/'mocktails' were the most common NAB type consumed (83.69%). Compared with respondents without AUD, those who screened positive for AUD were significantly more likely to consume NABs in an effort to decrease or abstain from drinking alcohol [adjusted odds ratio (AOR) = 3.54, 95% confidence interval (CI) = 2.24-5.58] and 67.97% endorsed less alcohol consumption (3.23% endorsed more) due to their NAB use. NAB consumption frequency and quantity were significantly positively predicted by alcohol consumption frequency (AOR = 1.46, 95% CI = 1.17-1.83) and quantity (β =0.25, 95% CI = 0.15-0.35), respectively. Adults who consume alcohol and screen positive for alcohol use disorder report drinking non-alcoholic beverages as a harm reduction strategy.

Alcohol Misuse and Sexually Transmitted Infections: Using the CAGE Questionnaire as a Screening Tool.

Background: While the connection between alcohol and risky behavior is well known, a clear correlation between alcohol misuse and contracting sexually transmitted infections (STIs) has not been determined. The 4-question CAGE questionnaire-the acronym stands for attitudes and activities related to alcohol use-is often administered at primary care annual visits to screen patients for alcohol abuse. This study assessed the relationship between CAGE scores and STI results to determine if the CAGE questionnaire could help determine the need for STI screening at annual visits. Methods: All patients who received a CAGE screening from 2015 to 2022 at a Gulf South health system were included in the analysis. The primary outcome of the study was the relationship between a positive CAGE score (a score ≥2) and a positive STI result. STIs included in the primary analysis were human immunodeficiency virus (HIV), hepatitis B, syphilis, chlamydia, gonorrhea, and trichomoniasis. The correlation between a positive CAGE score and hepatitis C was examined as a secondary outcome. Results: A total of 40,022 patients received a CAGE screening during the study period, and 757 (1.9%) scored ≥2 on the CAGE questionnaire. Significant associations were found between a positive CAGE score and hepatitis B (odds ratio [OR]=2.69, 95% CI 1.91, 3.80; P<0.001), gonorrhea (OR=5.43, 95% CI 1.80, 16.39; P=0.003), and hepatitis C (OR=2.10, 95% CI 1.57, 2.80; P<0.001). No associations were found between a positive CAGE score and HIV, chlamydia, or trichomoniasis. No patients with a CAGE score ≥2 had a syphilis diagnosis; therefore, no syphilis analysis was possible. Conclusion: Based on the results of this study, patients with a CAGE score ≥2 may benefit from screening for hepatitis B, hepatitis C, and gonorrhea at their primary care annual visit. Early STI detection could lead to prompt treatment and prevent further transmission and complications.

Association between long working hours and the onset of problematic alcohol use in young workers: A population-based longitudinal analysis in South Korea

BackgroundLong working hours can negatively impact mental health. We examined the association between long working hours and problematic alcohol use among young Korean workers. MethodsWe included a nationally representative sample of workers below the age of 40 from the Youth Panel between 2016 and 2020 (N = 7846; observations: 27,646). The exposure variable was working hours per week. Problematic alcohol use was assessed using the CAGE questionnaire, and generalized estimating equations were used to account for repeated measurements. ResultsObservations of the participants revealed that 5 % worked < 35 h/week, 51 % worked 35–40 h/week, 24 % worked 41–48 h/week, 11 % worked 49–54 h/week, and 9 % worked ≥55 h/week. The prevalence of problematic alcohol use among the workers was 2 % for <35 h/week, 2 % for 35–40 h/week, 3 % for 41–48 h/week, 4 % for 49–54 h/week, and 4 % for ≥55 h/week. The adjusted odds ratios (95 % confidence intervals) for the association between working hours per week and the onset of problematic alcohol use in the following year were 0.86 (0.45–1.66) for <35 h, 1.56 (1.22–1.99) for 41–48 h, 2.03 (1.49–2.75) for 49–54 h, and 1.68 (1.17–2.42) for ≥55 h, compared to 35–40 h. LimitationsThe observational design of the study prevented the establishment of a causal relationship between working hours and the onset of problematic alcohol use. ConclusionLong working hours were associated with the development of problematic alcohol use. Policy interventions should promote healthier drinking habits among workers with long work hours.

A Study to Assess the Prevalence of Depression among Alcoholics, among Patients, Admitted to Christian Institute of Health Sciences and Research, Dimapur, Nagaland

Abstract Background: Alcohol abuse is a significant global burden. Many families have been affected, and many are victims of its abuse. The effect ripple down not only in the life of the person abusing alcohol but also to the immediate and extended family members, which can be multiple and detrimental. Depression is one of the effects which can lead to further alcohol abuse. A vicious cycle is observed among the individual abusing alcohol, which in turn affects the other family members of the individual. Depression symptoms are common in alcohol abusing patients of all ages and are much more common than the diagnosable depressive disorder. Aims and Objectives: The current study aims to assess the prevalence of depression among alcoholics, among inpatients and also find the associations between the prevalence of depression and selected socio and clinical demographic variables. Materials and Methods: The method adopted by the study was descriptive study method using the total enumerative sampling technique. The CAGE questionnaire was used to screen out the patients for level of dependence. The tool used is the Patient Health Questionnaire-9 (PHQ-) to assess the prevalence. Descriptive and inferential statistics were used to analyze the study. Results: The study results revealed that 74.2% of the participants were depressed widely distributed in all the levels with severity assessed by the PHQ9 questionnaire. The study also indicated that a family history of alcohol abuse is significantly associated with the prevalence of depression among alcoholics. The study result strongly indicates that depression is very much prevalent among alcoholics, along with other multiple co morbidities. Conclusion: Patients abusing alcohol needs continuous and regular assessment for early identification and adopts strategies for the management of the same. The management of depressive symptoms through the adoption of various therapies such as psychotherapy, other alternative systems of therapies and recreational therapies are much recommended. The treating health care team should consider strongly the use of pharmacological means, if the patient is found to be having depression, in the course of treatment in the hospital.

P101 Baseline characteristics and cardiovascular risk of adults with plaque psoriasis treated with apremilast in UK clinical practice: a retrospective analysis of the British Association of Dermatologists Biologics and Immunomodulators Register

Abstract Apremilast is approved for use in moderate-to-severe plaque psoriasis (PsO) in adults not responding to or unsuitable for systemic therapy, with tolerability and efficacy demonstrated in randomized controlled clinical trials {Paul C, Cather J, Gooderham M et al. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized controlled trial (ESTEEM 2). Br J Dermatol 2015; 173:1387–99; Papp K, Reich K, Leonardi CL et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial [Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis (ESTEEM) 1]. J Am Acad Dermatol 2015; 73:37–49}. However, clinical trial populations are not always representative of the wider patient population treated in clinical practice. Our retrospective database analysis (funded by Amgen) assessed the characteristics of patients initiating apremilast in UK clinical practice and their risk of cardiovascular disease (CVD). From the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR), we included patients with a diagnosis of plaque PsO, aged ≥ 18 years, initiating apremilast between October 2015 and March 2021. Outcomes included Psoriasis Severity Index (PASI), Dermatology Life Quality Index (DLQI), EuroQol-5D questionnaire (EQ-5D), time from PsO diagnosis to apremilast initiation, previous treatments and future risk of CVD (Framingham Risk Score). We identified 265 eligible patients {47.5% (n = 126) female; median age at PsO diagnosis 23 years [interquartile range (IQR) 16–37]; median time from PsO diagnosis to apremilast initiation, 19.1 years (IQR 11.0–30.4); mean (SD) number of prior psoriasis therapies 1.6 (1.0), most frequently methotrexate (30%) and acitretin (28%)}. Adverse events were the most common reason for discontinuing prior treatments (33%). The median PASI score was 12.7 (IQR 10.4–17.0). Over half (59%) of all patients had a DLQI of &amp;gt; 10 (median 15; IQR 9–20). Approximately half (46%) reported a family history of PsO. The most common PsO manifestations were scalp (76%) and nails (53%); 18% of patients had comorbid psoriatic arthritis. Other common comorbidities were hypertension (23%), depression (22%) and dyslipidaemia (10%). The median body mass index was 29.9 kg m−2 (IQR 26.0–35.3); 21% of patients were current smokers and 11% were harmful/hazardous drinkers (CAGE questionnaire). Approximately one-third (32%) felt moderately anxious or depressed (EQ-5D). Over half (57%) reported moderate-to-extreme pain (EQ-5D). Ten (3.8%) patients had pre-existing CVD, four (1.5%) had angina pectoris, two (0.8%) had a history of myocardial infarction (0.8%) and four (1.5%) had history of stroke or transient ischaemic attack. Of 186 patients aged 30–74 years without pre-existing CVD, approximately two-thirds (61%) were at moderate or high risk (Framingham Risk Score ≥ 10) of developing CVD within 10 years. In conclusion, patients initiating apremilast in UK clinical practice had moderate-to-severe psoriasis, which affected their quality of life, specifically, pain, anxiety and depression. Cardiometabolic and psychiatric comorbidities were prevalent, with a high proportion of patients having a moderate-to-high risk of CVD.

Characteristics of the pancreas and liver state in chronic pancreatitis on the background of treated chronic viral hepatitis C depending on the international CAGE questionnaire testing results

Background. It was found that in 35–56% of patients, hepatobiliary diseases are considered to be a factor causing the formation or exacerbation of chronic pancreatitis (CP) while reducing the share of pancreatitis of alcoholic etiology, as it was previously believed. However, the role of the alcohol factor and its consideration in the treatment strategy for CP and comorbidity with chronic viral hepatitis C (HCV) also needs to be clarified, because it is known that excessive alcohol consumption and smoking increases the risk of developing pancreatitis by 8–17 times. The purpose is to conduct a comparative analysis of parameters of the structural and functional state of the liver and pancreas in patients with chronic pancreatitis associated with chronic viral hepatitis C treated etiotropically, depending on the results of testing according to the international CAGE questionnaire. Materials and methods. We have examined 100 ambulatory patients with CP and concomitant HCV, treated etiotropically. All patients were examined according to generally accepted algorithms. To clarify the effect of alcohol on the formation of CP and the state of patients with treated HCV, latent craving for alcohol was verified using the international CAGE questionnaire. The study on the density of the liver parenchyma and the pancreas was carried out not only according to the ultrasound data in the B-mode, but also with the simultaneous shear wave elastography on the Ultima PA scanning ultrasound device with the further measurement of the median of the parameters in kilopascals. Determination of the presence and depth of exocrine pancreatic insufficiency was carried out by the content of fecal elastase-1 evaluated using the enzyme immunoassay method. Results. Screening-testing of patients with CP on the background of HCV treated etiotropically using the CAGE scale made it possible to state that 65.0% of them had a latent craving for alcohol, and 21.0% of this cohort were women, which needs to be taken into account in the management of such patients. It has been proven that in the group with CAGE ≥ 2.0, functional and structural changes in the liver and pancreas were significantly more severe (deepening of the exocrine pancreatic insufficiency with a decrease in fecal α-elastase by 13.01%, an increase in the total index of the coprogram by 15.11% and the total ultrasound indicator of the pancreatic structure by 28.06%, and the total ultrasound indicator of the liver structure by 40.68% (р&lt;0.05)) and corresponded to the average degree of severity of the process in the pancreas according to the criteria of the Marseille-Cambridge classification, and in the group with CAGE&lt;2.0— only to a mild degree. Conclusions. The negative effect of the factor of increased alcohol use according to the CAGE was proven by increased density of pancreatic echotexture by 5.73% (p&lt;0.05), and of the hepatic echotexture by 5.16% (p&lt;0.05). According to the results of the correlation analysis on the dependence of the structural state of the liver and pancreas on the CAGE score, which were R=0.713, p&lt;0.05, and R=0.686, p&lt;0.05, respectively, there was found a strong direct dependence of the structural state of the liver and pancreas on the CAGE score, which proved an independent, reliably significant role of alcohol consumption for patients with a comorbid course of CP and HCV.

Psychometric Properties of the CAGE Questionnaire Amongst Middle-Aged and Older Adults in Khuzistan Province of Iran.

The CAGE questionnaire is an instrument, proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The questionnaire has been more pervasive simple tool than AUDIT and LAST scales to screen in busy medical settings where limited time is considered for adult patient interviews. The present study aimed to determine the reliability and validity of the CAGE questionnaire in Khuzistan province, Iran and evaluate its role in detecting alcohol-related problems. For this purpose, 382 men with mean age of 65 ± 5 were sampled by cluster-random sampling method in convenience model from the medical centers in eight counties of Khuzistan province during 2019 and they responded to the CAGE questionnaire. The coefficients of Cronbach's alpha (α = 0.82), convergent validity (0.73), divergent validity (-0.06), and criterion validity (0.87) were estimated (ρ < 0.01). The exploratory factor analysis demonstrated that the four -items related to the CAGE for the aged samples are organized into one factor, which clarifies 94% of the variance. Based on the results of the second-order confirmatory factor analysis, all factors were matched up well into a principal factor. Finally, the one -factor model was appropriate for the data by using the fit index techniques for adjusting the scale (AGFI = 0.81, TLI = 0.91, GFI = 0.93, RMSEA = 0.006, IFI = 0.94, NFI = 0.91, CFI = 0.97).The results could prove the well-adjusted reliability and validity of the CAGE and its usefulness for the relevant studies.

Addictions, Social Deprivation and Cessation Failure in Head and Neck Squamous Cell Carcinoma Survivors

To evaluate the evolution of addictions (tobacco and alcohol) and social precarity in head and neck squamous cell carcinoma survivors when these factors are addressed from the time of diagnosis. Addictions and social precarity in patients with a new diagnosis of HNSCC were assessed through the EPICES score, the Fagerström score, and the CAGE questionnaire. When identified as precarious/dependent, patients were referred to relevant addiction/social services. One hundred and eighty-two patients were included. At the time of diagnosis, an active tobacco consumption was associated with alcohol drinking (Fisher's exact test, p < 0.001). Active smokers were more socially deprived (mean EPICES score = mES = 36.2 [±22.1]) than former smokers (mES = 22.8 [±17.8]) and never smokers (mES = 18.9 [±14.5]; Kruskal-Wallis, p < 0.001). The EPICES score was correlated to the Fagerström score (Kruskal-Wallis, p < 0.001). Active drinkers (mES = 34.1 [±21.9]) and former drinkers (mES = 32.7 [±21]) were more likely to be socially deprived than those who never drank (mES = 20.8 [±17.1]; Krukal-Wallis, p < 0.001). A Fagerström score improvement at one year was associated to a CAGE score improvement (Fisher's exact test, p < 0.001). Tobacco and alcohol consumption were more than halved one year after treatment. Patients who continued to smoke one year after diagnosis were significantly more likely to continue to drink (Fisher's exact test, p < 0.001) and had a significantly higher initial EPICES score (Kruskal-Wallis, p < 0.001). At one year, addictions and social deprivation tend to improve when taken care of from the diagnosis. The most dependent patients and those with multiple frailties are at highest risk of cessation failure.

Mental health, wellbeing and burnout among medical students in the United Arab Emirates.

Medical students tend to experience high levels of stress during their studies, that can result in mental health disorders and burnout, further affecting academic performance and later ability to practice. To investigate previous and current mental health issues, significant sources of stress, burnout, and substance use among medical students in the United Arab Emirates (UAE). We conducted an online survey to collect data on demographics, sources of stress, mental health problems, burnout, and substance use in 385 medical students from the UAE University. We used the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire 12 (GHQ-12), and the CAGE questionnaire. Our results indicated that 5.7% of participants had been diagnosed with a mental health condition prior to joining medical school, and that 21.6% of participants were diagnosed with a mental illness while in medical school. On the OLBI, 77.4% screened positive for burnout (81.3% for disengagement and 95.1% for exhaustion), with 74.5% screening positive for mental health difficulties on the GHQ-12 and <1% screening positive on the CAGE for problem drinking. There was a statistically significant positive correlation between scores on the OLBI and the GHQ-12. Our study indicated that high levels of stress, burnout and mental illness are experienced among medical students in the UAE.

Serum Carbohydrate Deficient Transferrin: A Sensitive Marker in Diagnosing Alcohol Abuse

Introduction: Alcohol is a psychoactive substance with dependence producing properties and the burden of disease and death related to alcohol consumption remains significant in most countries. Early detection and proper medication with counselling can restore the alcoholics to normalcy. There is a need for a specific assay procedure to detect alcoholics early, so that proper therapy can be instituted. The traditional biomarkers in liver function test (LFT) are more frequently used for diagnosing alcohol abuse but they have variable and limited sensitivity and specificity. Carbohydrate Deficient Transferrin (CDT) can be considered as a more sensitive and specific marker for diagnosing alcohol abuse. The aim of this study is to determine % CDT in alcoholics and compare it with other alcohol markers in respect with sensitivity and specificity. The results of the study will be helpful in assessment of the alcohol dependence patients and therefore in their early detection and management. Materials and Methods: This is a hospital based comparative cross-sectional study carried out in Dharan. A total of 40 cases of alcohol abuse with ≥2 score in CAGE questionnaire and matched 40 subjects with no history of alcohol intake were enrolled in the study. Informed written consent and ethical approval were taken. Result: Serum %CDT has the highest diagnostic efficacy followed by serum gamma glutamyl transferase (GGT), Aspartate Transaminase (AST), Alanine Transaminase (ALT), AST/AL, and ALP as a biomarker for diagnosing alcohol abuse. Serum %CDT has the highest sensitivity with 97.5% and specificity of 73% at a cut off value of 3.5% compared to serum GGT with the sensitivity and specificity of 87% and 73%, respectively at a cut off value of 33.5 U/L. Conclusion: Serum %CDT is a better marker both in terms of sensitivity and specificity compared to other conventional markers and thus can be used as a tool to early diagnose the alcoholic cases and monitor the therapy and for early identification of the relapses in alcoholics during treatment.

THE STRUCTURAL AND FUNCTIONAL STATE OF THE PANCREAS AND LIVER IN CHRONIC PANCREATITIS IN COMBINATION WITH CHRONIC VIRAL HEPATITIS C DEPENDING ON THE INDEX OF THE SURVEY ACCORDING TO THE INTERNATIONAL CAGE QUESTIONNAIRE.

The aim: To conduct a comparative analysis of parameters of the structural and functional state of the liver and pancreas in patients with chronic pancreatitis in comorbidity with treated etiologically chronic viral hepatitis C, depending on the results of testing according to the international CAGE questionnaire. Materials and methods: 100 ambulatory patients with CP with concomitant HCV, treated etiotropically, were examined. All patients were examined ac-cording to generally accepted algorithms. To establish the role of alcohol on the formation of CP and the condition of patients with treated HCV, latent craving for alcohol was verified using the international CAGE questionnaire. The study of the density of the liver parenchyma and the liver of the patients was carried out not only according to the ultrasound data in the B-mode, but also with the simultaneous measurement of the shear wave elastography (SWE) method on the Ultima PA scanning ultrasound device with the further determination of the median of the parameters, which characterizes the stiffness in kilopascals (kPa). Determination of the presence and depth of pancreatic exocrine insufficiency (PEI) was carried out by the content of fecal elastase-1 (FE-1), which was determined by the enzyme immunoassay method. Results: Screening-testing of patients with CP on the background of etiotropically treated HCV using the CAGE scale made it possible to state that 65.0% of such patients had a hidden craving for alcohol, and 21.0% of this cohort were women, which needs to be taken into account in the management of such patients. It has been proven that in the group of patients with CAGE≥2.0, the level of functional and structural changes in the liver and liver was significantly more severe (according to the deepening of the PEI, a decrease in fecal α-elastase by 13.01%, according to an increase in the total index of the coprogram by 15.11% and the total US-indicator of the pancreas structure by 28.06%, and the total US-indicator of the liver structure - by 40.68% (p<0.05) and corresponded to the average degree of severity of the process in panceas according to the criteria of the Marseille-Cambridge classification, and in the group with CAGE<2.0 - only a mild degree. Conclusions: The negative effect of the factor of increased alcohol use according to CAGE was proven by increasing the density of the echostructure of the liver by 5.73% (p<0.05), and the liver by 5.16% (p<0.05). According to the results of the correlation analysis of the dependence of the structural state of the liver and PW of the studied patients on the value of the CAGE scale, which was R=0.713, p<0.05, and R=0.686, p<0.05, respectively, it was established that there is a strong direct dependence of the structural state of the liver and PW from the value of the CAGE questionnaire, which proved an independent, reliably significant role of alcohol consumption for patients with a comorbid course of CP and HCV.

Spanish validation of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and factors associated with physician burnout.

The aim of this study was to investigate the psychometric properties of the Spanish version of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and the factors associated with Physician Burnout in Paraguay. Participants included 747 Paraguayan healthcare workers, aged 24-77 years old, of both sexes. SOSS-D was translated into Spanish and validated through an exploratory and confirmatory factor analysis. Participants were also scored with the Oldenburg Burnout Inventory (OLBI), the CAGE questionnaire, and the stigma subscale of the Perceived Barriers to Psychological Treatment (PBPT) measure. Three factors had a raw eigenvalue greater than 1, and explained 61.7% of total variance. The confirmatory analysis confirmed that the scale is three-dimensional. The model adjustment was good, according to all fit indices. OLBI results indicate clinically significant disengagement in 85.9% and clinically significant exhaustion in 91.6% of participants. Of the 747 participants, 57.6% reported alcoholic beverage consumption and among those, 19.3% had problematic alcohol consumption according to the CAGE questionnaire. The correlation between SOSS-D and the stigma subscale of the PBPT was statistically significant (r = 0.245, p < 0.001). The Spanish version of the SOSS-D was found to have good psychometric properties and adequately reproduces the three-dimensional model of the original English version.

Predictors of the Quality of Life of University Students: A Cross-Sectional Study.

Quality of life (QOL) is a complex and multifaceted concept that has been used to study different aspects of people’s lives, including physical and psychological wellbeing, financial independence, social relationships, personal beliefs and living situation. In this study, we aimed to assess the QOL of a group of Spanish university students and identify associated factors. Method: We completed a cross-sectional study of the QOL of 868 university students using the WHOQOL-BREF questionnaire. In addition, data regarding sociodemographic information and self-esteem (Rosenberg Self-Esteem Scale), physical activity (International Physical Activity Questionnaire—Short version), diet (Spanish Index of Healthy Eating), alcohol consumption (CAGE questionnaire) and sleep quality (Pittsburgh Sleep Quality Index) were collected. Results: A total of 66.2% of participants assessed their QOL positively, while 58.8% favorably evaluated their overall health. Students reported the highest scores for the physical health domain of QOL, whereas they gave the lowest scores for the psychological health domain. Age was inversely associated with QOL. Higher self-esteem and satisfaction with academic performance, as well as sleep and diet quality, were directly associated with higher QOL. The physical health domain of QOL was scored more highly by participants who had a healthy body weight or those who reported moderate levels of physical activity. Higher scores in the social relationships domain of QOL were directly linked to alcohol intake, smoking and low body weight in addition to being inversely associated with screen time. The psychological domain of QOL was lower for those who were overweight or lived alone. Conclusion: Many sociodemographic, academic and behavioral variables are associated with university students’ QOL. The present findings underscore the need to direct further initiatives toward identifying and overcoming barriers to increased QOL for university students.

Associations of childhood trauma with long-term diseases and alcohol and nicotine use disorders in Czech and Slovak representative samples

ObjectiveThe abuse and neglect of a child is a major public health problem with serious psychosocial, health and economic consequences. The aim of this study was to assess the relationship between various types of childhood trauma, selected long-term diseases and alcohol and nicotine use disorder in Czech and Slovak representative samples.MethodsData on retrospective reporting about selected long-term diseases, alcohol and nicotine use disorder (CAGE Questionnaire) and childhood maltreatment (Childhood Trauma Questionnaire; CTQ) in two representative samples (Czech sample: n = 1800, 48.7% men, mean age 46.61 ± 17.4; Slovak sample: n = 1018, 48.7% men, mean age: 46.2 ± 16.6) was collected. Multinomial logistic regression models were used to assess the relationships between childhood maltreatment and long-term diseases.ResultsThere is a higher occurrence of some long-term diseases (such as diabetes, obesity, allergy, asthma) and alcohol and nicotine use disorder in the Czech sample; however, in the Slovak sample the associations between child maltreatment and long-term diseases are stronger overall. Emotional abuse predicts the occurrence of all the studied long-term diseases, and the concurrent occurrence of emotional abuse and neglect significantly predicts the reporting of most diseases. All types of childhood trauma were strong predictors of reporting the occurrence of three or more long-term diseases.ConclusionThe extent of reporting childhood trauma and associations with long-term diseases in the Czech and Slovak population is a challenge for the strengthening of preventive and therapeutic programmes in psychosocial and psychiatric care for children and adolescents to prevent later negative consequences on health.

Evaluation of mood disorder questionnaire positivity and associated factors in a population-based screening study

The Mood Disorders Questionnaire (MDQ) is a 3-item scale that is frequently used in bipolar disorders (BD) screening and questions the symptoms of BD, its effect on functionality, and the coexistence of symptoms. The aim of this study is to evaluate the prevalence of positive screening of the MDQ among general population and to investigate the associated risk factors.In this cross-sectional study, the sample was randomly selected from household data to represent the city population. A total of 432 participants were asked to fill in MDQ, CAGE (cutting down, annoyance by criticism, guilty feeling, and eye-openers) questionnaire, which consists of four clinical interview questions proven to aid in the diagnosis of alcoholism, and clinical and sociodemographic data form.The Cronbach’s alpha value of our current study was 0.813 for MDQ. The prevalence of MDQ positivity was found 7.6%. The estimated prevalence rate of bipolar disorders varied between 0.3 and 13.4% according to different cut-off values. Multivariate logistic regression models showed that the presence of possible alcohol addiction, shift work history, and body mass index (BMI) were statistically significant predictors of MDQ positivity.The prevalence of MDQ positivity found is similar to studies in literature. Keeping in mind that psychometric properties of the MDQ, positive screen results should be cautiously interpreted due to the presence of other risk factors and comorbidities.