Alcohol Dependence Research Articles

Preparation of disulfiram-Cu2+-polylactide nanofibrous membranes via electrostatic spinning and evaluation of their in vitro anticancer effects

The antitumor effects of disulfiram (DSF) —a conventional medication used to treat alcohol dependence—have been documented in numerous studies. However, because of its low water solubility and Cu2+-dependent anticancer effects, the application of DSF in cancer therapy has been limited. Nanofibrous membranes produced via electrospinning have large specific surface areas. Consequently, they have been extensively used in biomedical applications, such as tissue scaffolding, drug delivery. In this study, a polylactic acid nanofibrous membrane was designed to encapsulate Cu2+ and DSF. The encapsulated drug was released when the membranes came into contact with the tumor tissue. DSF functioned as a Cu-ion carrier and combined with Cu2+ to induce tumor-cell apoptosis. The anticancer properties of the drug-loaded nanofibrous membrane were verified at the cellular level using in vitro experiments with cells. The results indicated that DSF and Cu2+ were released from the fiber membrane, and the combination of DSF and Cu2+ exhibited a better of cancer are proposed.

Altered Mitochondrial DNA Copy Number and Telomere Length in Patients with Substance Use Disorder: Correlation with Age, Sex, and Chronic Diseases.

Substance use disorder (SUD) is a complex condition involving psychological, sociocultural, and genetic factors. In this study, we examined the alternations in mitochondrial DNA copy number (mtDNAcn) and telomere length (TL) and their relationship to demographic, medical, heredity, and substance use characteristics in patients with SUD and healthy controls. We investigated a total cohort of 54 participants: 21 healthy individuals, 17 patients with alcohol dependence (AD), and 16 patients with drug dependence (DD). TL and mtDNAcn were measured using quantitative real-time PCR, with statistical methods used to assess the association between variables. We observed a significant decrease in mtDNAcn in both SUD groups, particularly associated with chronic diseases in the AD group. No significant differences in TL were found among the three groups. Sex-associated analysis revealed a significant mtDNAcn reduction in the DD males and elevated TL in AD males compared to control males. Correlation analyses showed associations between the two biomarkers and age, sex, and chronic diseases. Our findings suggest that leukocyte mtDNAcn is a more sensitive marker than TL in patients with SUD, indicating sex-specific patterns of alterations. These findings require confirmation through larger cohort recruitment.

Impact of alcohol use disorder on antiretroviral therapy adherence in adults with HIV/AIDS at University of Gondar, Northwest Ethiopia

Background Alcohol use disorder in people living with the human immunodeficiency virus is an important public health problem associated with high rates of HIV infection and lower antiretroviral treatment adherence. However, little is known about the prevalence of alcohol use disorders and its impact on ART adherence among people living with HIV/AIDS (PLWHA). Thus, this study aimed to evaluate the magnitude of alcohol use disorder and its impact on medication adherence among PLWHA attending the ART clinic. Methods A hospital based cross sectional study design was conducted at University of Gondar Comprehensive Specialized Hospital (UOGCSH) ART clinic from September 30, 2023 to February 30, 2024. The World Health Organization’s Alcohol Use Disorders Identification Tool (AUDIT) was utilized to assess alcohol use disorder. Bivariate and multivariate logistic regression analyses were employed to investigate the relationship between AUDs and other variables. Statistical analysis was conducted using SPSS version 26, with a significance level set at P < 0.05. Results The overall prevalence of AUDs was 38.8%, with hazardous use, harmful use, and alcohol dependence accounting for 24.6%, 6.1%, and 8.1% of the total, respectively. In addition, 67.8% of the participants had medication adherence above 95%. Factors associated with alcohol use disorder were male AOR = 1.52; 95% CI (1.01, 2.30), cigarette smoking AOR = 2.384, 95% CI (1.183, 4.80), educational status AOR = 1.96, 95% CI (1.016, 3.764), and age 45–57 years AOR = 3.05, CI (1.587, 5.871). In present study, compared with social drinkers, harmful drinkers and alcohol dependents showed low medication adherence under 95% (AOR = 4.08 and AOR = 8.89, respectively). Conclusion The study reveals a high prevalence of alcohol use and dependence in PLWHA, underscoring the need for effective detection and intervention strategies particularly for males, cigarette smoker, and age between 54 and 75 years in healthcare and community settings. Alcohol use is strongly associated with poor adherence to antiretroviral therapy (ART). Individuals with hazardous alcohol use are four times more likely to have low adherence, while alcohol-dependent individuals are nearly nine times more likely to have low adherence compared to social drinkers.

Microvesicle Tissue Factor Procoagulant Activity Is Elevated and Correlated With Disease Severity in Patients With Cirrhosis.

Tissue factor-expressing microvesicles (MV-TF) have been found to correlate with thrombotic complications in various diseases. Simultaneously, there is expanding research regarding the effect of the coagulation cascade on liver fibrosis progression. The aim of our manuscript was to evaluate MV-TF activity in patients with cirrhosis and its correlation with disease severity. We prospectively enrolled 82 patients [11 with cirrhosis and hepatocellular cancer (Group 1), 50 with cirrhosis (Group 2) and 21 controls (Group 3)]. Extensive workup for disease staging and exclusion criteria was undertaken. Exclusion criteria included thrombophilia, history of thrombosis, recent hospitalisation, ongoing infection, alcohol dependence, cancer, haematological diseases and use of anticoagulant, antiplatelet or contraceptive drugs. Plasma tissue factor antigen concentration and MV-TF activity were assessed. MV-TF showed median values of 4.03 [1.57], 3.17 [1.59] and 2.26 [1.23] pg/mL in Groups 1, 2 and 3, respectively. There was a statistically significant difference between Groups 1 and 3 (p < 0.001) and Groups 2 and 3 (p = 0.003), while Group 1 had higher values than Group 2 without statistical significance (p = 0.088). In Group 2, the patients' Child-Pugh (CP) stage was A in 56%, B in 26% and C in 18% of cases. MV-TF activity significantly correlated with decompensated cirrhosis (p = 0.005) and higher CP stage (p = 0.011). Finally, MV-TF activity significantly correlated with 12-month mortality (p = 0.021). MV-TF activity is elevated in patients with cirrhosis, showing a significant correlation with disease severity. MV-TF may play a role in the procoagulant imbalance of liver cirrhosis and their contribution in disease progression should be studied further.

One stone, three birds: Construction of Cu/ZIF-8@DSF@GOx/HA nanoplatform for synergistic starvation therapy enhanced chemo−/chemodynamic therapy

Disulfiram (DSF), as a sixpenny drug for the treatment of alcohol dependence, has demonstrated copper-dependent chemotherapy (CT) effects in recent years. However, as the most common modality in clinical treatment, prolonged use of CT will lead to multidrug resistance (MDR). In this work, a versatile and ingenious nanoparticle Cu/ZIF-8@DSF@GOx/HA (CZDGH) was constructed to deliver DSF, Cu2+ and GOx to tumor cells. Once internalized by tumor cells, GOx depletes glucose blocking the energy supply leading to ST. Then DSF chelates with Cu2+ in situ to generate CuETs, achieving toxicity-intensified CT, the reduced ATP in this process also inhibits the efflux function of both P-gp and CuETs. In the meantime, Cu2+ consumes glutathione (GSH) to enhance oxidative stress, and the converted Cu+ catalyzes internal and external sources of H2O2 into •OH, heightening chemodynamic therapy (CDT). The experimental results demonstrate remarkable multimodal synergistic anticancer effects that overcome MDR.

Effectiveness of Guided Imagery on Level of Perceived Stress and Depression Among Sober Alcohol Dependents Admitted in De-Addiction Centers of Selected Areas

Introduction: Alcohol abuse poses significant health challenges, affecting individuals and families. Guided imagery therapy offers a promising approach to manage stress and emotions, potentially mitigating the impacts of alcoholism and depression. Methodology: This study employed a quasi-experimental, non-randomized control group design with a quantitative approach to assess the effectiveness of guided imagery therapy on perceived stress and depression in sober alcohol dependents at selected de-addiction centers. Baseline characteristics, including age, gender, education, family type, occupation, income, and duration of alcohol use, were collected using Tool I. Stress levels were measured with the 5-point Perceived Stress Scale (Tool II), while the 4-point Hamilton Depression Scale (Tool III) assessed depression. Written permission from de-addiction authorities and informed consent from participants were obtained. The sample included 60 sober alcohol dependents from Maharashtra, selected via non-probability purposive sampling. Test-retest reliability for stress and depression was confirmed, with scores of 0.89 and 0.90, respectively. Result: The study assessed the effectiveness of guided imagery therapy on perceived stress and depression among sober alcohol dependents using a quasi- experimental design. In the experimental group, pre-test data revealed that 60% experienced severe perceived stress, which decreased to 66.66% at moderate levels post-intervention, demonstrating significant improvement (t-value: 20.018). Conversely, the control group showed no change, with 80% remaining in the severe category pre- and post-test (t-value: 0.1054). Similarly, for depression, the experimental group reported 63.34% severe depression pre-test, reducing to 70% at moderate levels post-test (t-value: 7.907), while the control group exhibited no significant change. Analysis of associations with demographic variables revealed no significant correlations for age, education, family type, or occupation; however, a significant relationship was found between the duration of alcohol consumption and depression levels (chi-square: 8.948). Conclusion: Thus, guided imagery therapy effectively perceived stress and depression reduced among the experimental group.

The Efficacy of Motivational Enhancement Therapy in Enhancing Readiness to Change Among Individuals with Alcohol and Substance Use Disorders: A Multi-Case Study

Substance use disorders (SUDs), encompassing alcohol and drug dependency, pose significant global health challenges. Motivational Enhancement Therapy (MET) has emerged as a client-centered intervention to enhance intrinsic motivation for behavioral change, particularly among individuals with ambivalence or resistance to conventional treatment approaches. This study examines the efficacy of MET in enhancing readiness to change in seven male patients undergoing inpatient rehabilitation for alcohol and substance use disorders through a multi-case study design. Each patient was evaluated using the Stages of Change Model (Prochaska &amp; DiClemente, 1983) to assess motivational shifts over the intervention period. Results indicated that MET facilitated progression to advanced stages of change for most participants, with notable improvements in readiness to change for five of the seven cases. However, variability in outcomes highlighted the influence of individual factors such as baseline motivation and co-occurring conditions. Findings suggest MET’s utility as a tailored approach to addressing substance use, emphasizing its importance in clinical practice.

Virtual Reality Exposure Therapy Protocol for Post-Traumatic Stress Disorder Treatment in Military Veterans: Cross-Cultural Adaptation of Virtual Exposure Therapy in Ukraine

Introduction. The integration of virtual reality technologies into PTSD treatment in Ukraine presents new opportunities for enhancing the mental health of military personnel, veterans, and individuals affected by war-related trauma. During military operations, soldiers often experience intense stress, anxiety, and intrusive memories, which can lead to PTSD. VR therapy uses fully and partially immersive technologies to create a safe virtual environment where patients can explore and process traumatic experiences under the guidance of a qualified specialist. The use of VR technologies for PTSD treatment during the ongoing conflict in Ukraine may become a crucial tool for addressing and healing trauma in both military personnel and civilians. This method provides a structured setting that fosters emotional processing and therapeutic engagement, aiming to alleviate psychological burdens and improve mental health outcomes. Purpose: To conduct a cross-cultural adaptation of the physiologically facilitated Virtual Reality Exposure Therapy (VRET) protocol with gradually increasing exposure, develop a Ukrainian version of the protocol tailored to the specific needs of Ukrainian PTSD patients, create VR technology and content that reflect the unique aspects of the Ukrainian war experience, and pilot test this protocol with a focus group of Ukrainian war veterans diagnosed with PTSD and carrying war-related traumatic memories. Methodology: For the cross-cultural adaptation of the Virtual Reality Exposure Therapy (VRET) protocol, a physiologically facilitated version with gradually increasing exposure was selected. This protocol was translated by two independent translators, followed by synthesis into a single version, back-translation, analysis, and final approval by a working group. The finalized Ukrainian version was prepared for field studies with a focus group of Ukrainian war veterans (n=50). All veterans underwent diagnostic assessments both before and after the VRET intervention, using the following standardized scales: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD evaluation, the Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety disorders, the Patient Health Questionnaire-9 (PHQ-9) for depression, the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicidal intentions, the Short Form Survey (SF-36) for quality of life, and the Alcohol Use Disorders Identification Test (AUDIT) for alcohol dependence. A series of VR scenarios were developed specifically to address the needs of Ukrainian war PTSD patients, designed to trigger common PTSD responses. A unique administrative panel was also created for therapists to adjust the presence and intensity of various triggers in real time, allowing for personalized tuning of the VR experience throughout the session. Results: Over a 6-month period, 50 Ukrainian war veterans participated in the study to assess the effectiveness of the adapted Ukrainian version of the VRET protocol for PTSD treatment. Comparison of baseline and post-intervention assessments showed significant improvements in clinical outcomes, including reductions in PTSD symptoms, anxiety, depression, and an overall improvement in quality of life. Conclusions: The cross-cultural adaptation and testing of the Virtual Reality Exposure Therapy protocol with a focus group of Ukrainian veterans with PTSD demonstrated reductions in PTSD symptoms, anxiety, and depression, alongside improvements in quality of life. Virtual reality allowed veterans to safely re-experience traumatic events under professional supervision, with gradually increased realism, enhancing the therapy's effectiveness. This method also reduces stigma by offering a confidential setting for therapist interaction, showing substantial promise in helping veterans manage their mental health more effectively

Validity of prenatal AUDIT screening for alcohol disorders – a Nationwide Swedish register study

Objective: This study aims to assess the external validity of the Alcohol Use Disorders Identification Test (AUDIT) in Swedish prenatal care as an indicator for alcohol-addiction disorders, and to characterize women with mismatched information in healthcare registers Design: This study was designed as a National register-based study. Setting: Sweden Participants: The study sample included 739,735 pregnancies over the period 2014–2020. Methods: Prospectively collected prenatal AUDIT screening in the Swedish Pregnancy register was linked to national health databases through individual identification number. The AUDIT score was dichotomized into &lt; 6 points (low-risk use) and ≥ 6 points (hazardous use). Alcohol addiction disorders were defined by a diagnostic code in The Swedish National Patient Register or drugs dispensed for alcohol dependence in the Swedish Prescribed Drug Register. Primary Outcome Measures: The diagnostic properties of AUDIT were assessed based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and accuracy (proportion of true positive and true negative) for an AUDIT score of ≥ 6 points for alcohol disorders. Women with mismatched information in the register were characterized and assessed by multinominal logistic regression, using women with matched information in the registers for reference. Results: An alcohol-related disorder was recorded in 3.1%, while 25,770 (3.5%) had an AUDIT point ≥ 6. The diagnostic accuracy of the AUDIT ≥ 6 points for detection of an alcohol related disorder during a year prior to pregnancy was 95.7% (95% confidence interval [CI]: 95.7, 95.8), with a positive LR of 8.03 (95% CI: 7.5, 8.6). The sensitivity for detecting a pre-pregnancy alcohol related disorder was 33.0% (95% CI: 30.9, 35.1). Being young, nulliparous, of low education, and of Swedish origin increased the likelihood of being misclassified with the AUDIT. Prior psychiatric care was associated with false negatives, especially for women with neuropsychiatric disorders (odds ratio [OR]: 10.39, 95% CI: 9.89, 10.90). Conclusions: The accuracy of AUDIT in screening for alcohol disorders at a population-based level was high, but only identified one third of women with alcohol-related disorders when using a cut-off of six points criterion.

Problematic alcohol consumption among management undergraduates of Bhaktapur District, Nepal

BackgroundAlcohol consumption is a significant public health concern among young people worldwide. While alcohol use is culturally embedded in many Nepalese communities, evidence regarding the prevalence of problematic drinking and its associated factors remains scarce among youths. This study aims to assess the prevalence of alcohol consumption and problematic drinking and their associated factors among management undergraduate students of Bhaktapur, Nepal.MethodA cross-sectional study was conducted among 304 undergraduate students in Bhaktapur, Nepal. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess problematic drinking. Pearson’s chi-square test and multivariable logistic regression analysis were performed to determine factors associated with alcohol consumption and problematic drinking, at the 5% level of significance.ResultsThe prevalence of alcohol consumption was 58.2% (95% CI:52.0-63.6%), with 26.6% (95% CI: 19.2–33.1%) exhibiting problematic drinking. Being male (aOR: 2.05, 95% CI:1.11–3.76), dissatisfaction with academic performance (aOR: 2.43, 95% CI:1.35–4.38), and alcohol preparation at home (aOR: 2.54, 95% CI: 1.20–5.40) were associated with alcohol consumption. Problematic drinking was linked to male gender (aOR: 4.03, 95% CI: 1.71–9.46), living in a joint family (aOR: 2.40, 95% CI: 1.09–5.29), poor perceived emotional support from family (aOR: 4.94, 95% CI: 1.50-16.26), and traumatic experience (aOR: 2.68, 95% CI: 1.19–6.02).ConclusionThis study revealed the concerning prevalence of alcohol consumption and dependency among Nepali undergraduate students. These findings highlight the need for comprehensive interventions targeting gender, the family environment, and academic factors to address alcohol misuse among Nepali youth.

Neuropsychological Abnormalities Associated with Alcohol Dependence During Long-Term Rehabilitation Treatment of German Inpatients.

Alcohol dependence is associated with several neuropsychological abnormalities, such as increased impulsivity or attentional bias towards drug-related stimuli. However, it is debated whether these abnormalities are on the decline after long-term abstinence from alcohol. Inpatient rehabilitation treatment enables the longitudinal investigation of such variables during a long, largely secured, period of abstinence. This study involved alcohol-dependent patients consecutively admitted for a duration of 14-26 weeks to an inpatient rehabilitation treatment center located in a hospital specializing in substance use disorders. Craving and impulsivity were assessed with the means of two questionnaires (e.g., OCDS-G and BIS-11); conversely, attentional bias and problems with inhibition were measured with the help of two computer-based experiments (e.g., dot-probe task and stop-signal-reaction task). Investigations were conducted at entry, after 6 weeks, and during the last two weeks of the inpatient treatment. A total of 130 patients with alcohol dependence (mean age 43.3 years; 78.5% male) completed the first, N = 102 the second, and N = 83 the final assessment. Over the whole period of inpatient treatment, there was a significant decrease in patients' scores for both craving (t(83) = 7.8, p < 0.001) and impulsivity (t(82) = -3.75, p < 0.001, t(82) = 4.4, p < 0.001). However, there were no significant changes regarding attentional bias (t(82) = 0.16, p = 0.494) and inhibitory control (t(76) = 0.04, p = 0.482) scores. Neuropsychological abnormalities associated with alcohol dependence might persist even after a long abstinence period. The decrease in both craving and impulsivity levels may be explained by the protected, alcohol-free, hospital environment; however, patients' risk of post-discharge relapse may remain high, as the basic neurobiological mechanisms of alcohol dependence may persist for long periods, and possibly for more than 3-6 months.

A nomogram for predicting the transition from recurrent acute pancreatitis to chronic pancreatitis

Abstract Objectives: Acute pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis are recognized as a continuum of pancreatic diseases. Recurrence increases the risk of progression to chronic pancreatitis. The aim of this study was to search for clinical features that may promote the progression of chronic pancreatitis in patients with recurrent acute pancreatitis. Methods: We retrospectively reviewed patients with recurrent acute pancreatitis from Medical Information Mart for Intensive Care-IV database. They were divided into a training cohort and a validation cohort. A nomogram was constructed based on clinical features during the second hospitalization. The discrimination and calibration of the nomogram were evaluated using the concordance index, area under the time-dependent receiver operating characteristic curve, and calibration plots. Results: A total of 432 recurrent acute pancreatitis patients were evaluated, of which 93 (21.53%) were diagnosed with chronic pancreatitis later. Age, biliary pancreatitis, admission interval, alcohol dependence, lipase, and platelet were selected. The concordance index was 0.717 (95% CI: 0.691-0.743) for the training cohort and 0.718 (95% CI: 0.662-0.774) for the validation cohort. The area under the time-dependent receiver operating characteristic curve was &gt;0.7 over 1000 days. Conclusions: A nomogram was developed and validated to evaluate the transition from recurrent acute pancreatitis to chronic pancreatitis.

One-year ecological momentary assessment of alcohol use, mood, and stress among individuals with alcohol use disorder during SARS-CoV-2 pandemics: a gender-specific reflection.

Alcohol consumption (AC) is a leading risk factor for death, morbidity, and disability worldwide. Gender-specific differences in AC and its moderators, which may serve as markers for preventing severe alcohol use disorders (AUD), showed inconsistent results. Additionally, the impact of COVID-19-related lockdowns on these differences remains unclear. We examined gender-specific differences in short- and long-term factors affecting AC in individuals at risk for alcohol dependence, focusing on mood, stress, and the influence of restriction-dependent lockdown phases. 358 subjects with AUD aged 16 to 65 were studied over one year. Daily electronic diaries and monthly questionnaires were conducted from 10/01/2020 to 09/30/2021, assessing real-world trajectories of AC, mood (MDMQ), and stress (PSS-10) during Germany's second COVID-19 wave. Multi-level models were used to assess associations between these measures and with several within- and between-subject variables. During lockdown, women experienced lower and even decreasing mood (valence: β = -0.2, p < .039; calmness: β = -0.3, p < .010), while men's mood increased from the most restrictive lockdown phase (valence: β = 0.2, p < .001; calmness: β = 0.3, p < .001) to post-lockdown (valence: β = 0.5, p < .001; calmness: β = 0.6, p < .001). Stress increased earlier (β = 0.8, p < .001) and more prolonged (β = 0.4, p = .021) in women than in men. For both genders, daily mood was positively associated with daily AC (valence: β = 0.6, p = .004; calmness: β = 0.4, p = .013), leading to stronger drinking on days with elevated mood. Conversely, average mood was negatively associated with average AC (valence: β = -1.6, p = .011; calmness: β = -1.2, p = .041), indicating higher overall consumption with worse overall mood. Our findings highlight the need for interventions targeting mental distress in women with AUD during pandemics, as this group faces increased mental burden during social isolation and increased risk of alcohol dependence during persistent distress.

Selective Serotonin Reuptake Inhibitors for Cessation of Betel Quid Use in Patients with Major Depressive Disorder in Taiwan.

Background/Objectives: Major depressive disorder (MDD) frequently co-occurs with substance use disorders such as alcohol and nicotine use disorders. Comorbid substance use disorders worsen the clinical symptoms of MDD and exacerbate addictive behaviors and presentations. However, the relationship between MDD and betel quid use disorder (BUD) in Taiwan has not been extensively investigated. Methods: We performed this cross-sectional study investigated associations between betel quid use, BUD, and MDD specifically in the Taiwanese population. Long-term betel quid use is a major public health concern, contributing significantly to the high incidence of oral cancers, which rank fifth among the top ten most common cancers in Taiwan. Results: Among patients with MDD, the current BUD prevalence rate was 7.32%, and the lifetime BUD prevalence rate was 15.45%. Patients with comorbid BUD were more likely to have severe alcohol and nicotine dependence disorders and required longer antidepressant treatment. Conclusions: Notably, 16.98% of patients with comorbid BUD who received selective serotonin reuptake inhibitor treatment achieved abstinence. BUD has a detrimental effect on health outcomes in patients with MDD, and selective serotonin reuptake inhibitor treatment may be required to be prolonged for betel quid abstinence therapy to be effective. Additional studies should investigate medication therapies for betel quid addiction disorders.

The Relationship between Motivation, Coping Mechanisms, and Alcohol Cessation among Alcohol Drinkers in Barangay Ubaldo Laya, Iligan City

Background and Aim: Alcohol consumption remains a prevalent and varied practice across cultures worldwide. This study aimed to investigate the level of motivation, coping strategies, and alcohol cessation among individuals attempting to cease alcohol consumption. In addition, this study aimed to explore the relationships between motivation, coping mechanisms, and alcohol cessation among alcohol drinkers in the Philippines. Design: This study employs a descriptive-correlational design. Using convenient sampling, it targets male and female residents aged 18–59 years old in Iligan City, Lanao del Norte, Philippines, who have attempted to quit alcohol consumption. Results: Personal growth and development, relationships, and physical appearance were the primary motivators for alcohol cessation. Effective coping mechanisms included confronting negative emotions, boosting mood through special treats or increased productivity, and reflecting on past drinking consequences. Respondents reported significant improvements in well-being, excellent stress management, and strong support from groups and family, leading to increased confidence in maintaining cessation, infrequent alcohol consumption, and success in quitting. Individuals with higher motivation and effective coping strategies were more likely to maintain cessation, manage stress without alcohol, attend support sessions, and experience overall well-being improvements. Conclusion: These results suggest that targeted interventions that enhance motivation and provide effective coping mechanisms are essential. Counseling, support groups, and educational programs emphasizing personal growth, strong relationships, and self-improvement can achieve this. These findings are valuable for health-care providers, counselors, and policymakers, highlighting key factors for successful alcohol cessation. By focusing on motivation and coping mechanisms, support systems can improve the likelihood of sustained alcohol cessation, leading to better community health and well-being.

ADVANCEMENTS IN UNDERSTANDING AND MANAGING ALCOHOL WITHDRAWAL SYNDROME: A COMPREHENSIVE REVIEW

Alcohol withdrawal syndrome (AWS) is a clinically significant condition that can arise upon abrupt cessation or reduction of alcohol consumption in individuals with alcohol dependence. This review article provides a comprehensive overview of AWS, encompassing its epidemiology, pathophysiology, clinical manifestations, assessment tools, and management strategies. We discuss the neurobiological mechanisms underlying AWS, including the role of neurotransmitter systems such as gamma-aminobutyric acid (GABA) and glutamate, as well as neuroadaptive changes that occur with chronic alcohol use. Furthermore, we explore the spectrum of clinical manifestations associated with AWS, ranging from mild withdrawal symptoms to severe complications such as delirium tremens and seizures. Diagnostic tools and scoring systems commonly used for assessing AWS severity are examined, along with evidence-based approaches for pharmacological and non-pharmacological management of AWS. Additionally, we highlight emerging research areas and future directions in the field of AWS, including novel treatment modalities and potential biomarkers for predicting withdrawal severity and treatment response. This comprehensive review aims to provide clinicians, researchers, and healthcare professionals with a thorough understanding of AWS to facilitate early recognition, appropriate management, and improved outcomes for individuals affected by this condition.

Serum and Oral Fluid Levels of Protein Markers and Hormones in Patients With Alcohol Dependence Syndrome

Background: The development of alcohol dependence syndrome is accompanied by disturbances of neuroplasticity in neural circuits, the imbalance of neurotransmitter metabolism and immune and hormonal statuses in the central nervous system, which are reflected in changes in peripheral markers. Therefore, determining neuropeptide levels in body fluids is a potentially promising strategy for laboratory monitoring of substance use.Objective: To determine characteristics of changes in oral fluid and serum levels of protein markers and hormones in patients with alcohol dependence syndrome during rehabilitation.Materials and methods: We formed 2 groups of male participants: a control group of apparently healthy volunteers (n = 30) and a group of patients with alcohol dependence syndrome, which was similar in size, age, and gender (20-40 years) to the controls. At the time of admission to the rehabilitation program and 3 months later, serum and oral fluid samples were collected. We used an enzyme-linked immunosorbent assay to determine levels of brain-derived neurotrophic factor (BDNF), glial cell line–derived neurotrophic factor, neuropeptide Y, orexin, pituitary adenylate cyclase-activating peptide, corticotropin, and cortisol in the body fluids.Results: Laboratory findings revealed that it is possible to determine neuropeptides and hormones in the oral fluid. The wide variability of findings in the oral fluid and no statistically significant correlation with corresponding serum levels were characteristic of the most protein markers. Only the BDNF levels were statistically significantly reduced (3.2-fold decrease) in both the serum and oral fluid. Analysis of the serum and oral fluid BDNF and cortisol levels revealed a moderate correlation (r = 0.51, P = .0189).Conclusions: For laboratory monitoring of alcohol dependence syndrome, it is possible to determine oral fluid BDNF, which, like cortisol, has demonstrated a statistically significant moderate correlation between the serum and oral fluid levels.

Effectiveness of Rational Emotive Behavior Therapy on Level of Stress and Anxiety among Sober Alcohol Dependents Attending Self Help Groups in Selected Areas

ABSTRACT Introduction: Stress and anxiety are common, especially in challenging situations. Rational Emotive Behavior Therapy (REBT) helps manage these by addressing irrational thoughts. It is also effective in reducing emotional distress linked to alcohol addiction. Methodology: This study evaluates the levels of stress and anxiety among sober alcohol dependents attending self-help groups and assesses the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing these levels. A quantitative, quasi-experimental non-randomized control group design was used, with 60 participants (30 in the control group and 30 in the experimental group) selected through convenience sampling. Conducted over 28 days, the research setting included selected self-help groups. Reliability scores for the stress and anxiety assessment tools were high (0.99) based on the test-retest method, ensuring the study's credibility. A pilot study confirmed feasibility for larger-scale research. The findings provide key insights into REBT's role in improving mental health among sober alcohol dependents. Result: The study demonstrated that Rational Emotive Behavior Therapy (REBT) is significantly effective in reducing both stress and anxiety among sober alcohol dependents attending self-help groups. For stress, pretest results in the experimental group showed 43.3% of participants had moderate stress and 56.7% had high stress. Posttest results revealed substantial improvement, with 33.3% reporting low stress and 66.7% reporting moderate stress. The paired t-test showed a significant reduction in stress scores, with an average decrease from 26.8 to 16.6 (p-value &lt; 0.05). Similarly, anxiety levels improved significantly. In the experimental group, pretest anxiety results showed 56.7% with moderate anxiety, which dropped to 13.3% posttest. The paired t-test revealed a significant decrease in anxiety scores from 26 to 15.3 (p-value &lt; 0.05). Comparison between experimental and control groups also confirmed the significant impact of REBT on reducing both stress and anxiety levels. Conclusion: The findings suggest that REBT is a highly effective intervention for managing stress and anxiety in sober alcohol dependents.

Prevalence of mental illness and associated factors among the elderly in Ogun East Senatorial District, Nigeria

Abstract Background: Mental health problems are common in the elderly; they often go unnoticed, ignored, untreated, or considered part of normal aging. About a quarter of the Nigerian population have mental health problems, out of which 3.26% are elderly. Aim: This study aimed to determine the prevalence, types, and factors associated with mental illnesses among the elderly. Materials and Methods: This was a community-based cross-sectional survey of the elderly. Four hundred and two elderly people were selected by a multistage sampling technique and were interviewed using semi-structured questionnaires. Data analysis was done using the IBM SPSS Statistics version 22.0. Descriptive statistics were summarized using proportion and presented in frequency tables. Bivariate analyses were done using the Chi-square test and logistic regression analyses. The level of significance was set at a 95% confidence interval with P &lt; 0.05. Results: The prevalence of mental illness among the elderly respondents was 35.8%. Of all the mental illnesses, generalized anxiety disorder ranked the highest (15.4%), followed by current alcohol dependence (14.9%). The factors found to be associated with mental illness in the elderly included monogamous family type (odds ratio [OR] = 0.211, P = 0.034) and monthly income &lt;50,000 Naira (OR = 85.108, P = 0.003). Conclusion: This study revealed that the prevalence of mental illness was high among the community-dwelling elderly respondents of Ogun East Senatorial District. The determinants of mental illness among the elderly were monthly income of &lt;50,000 naira, while monogamous family type was found to be protective of mental illness in the elderly.

The effectiveness of antidepressant therapy against anhedonia in patients with alcohol dependence

The article presents the results of a scientific study aimed at determining the effectiveness of the drug Vortioxetine (Brintellix) in the treatment of affective spectrum disorders in patients with alcohol dependence in a drug treatment hospital, since the drug is promising for widespread use in the drug therapy of a number of mental disorders and in the future could be included in the standard of medical care in the field of psychiatry-addictology. It is known that anhedonia is one of the mental disorders in withdrawal syndrome, which provokes relapses of an addictive disorder and negatively affects the duration and quality of remissions of patients with an addiction profile. At the same time, the study of antidepressant therapy in the treatment of alcohol dependence remains relevant, since poor tolerance, side effects, and deterioration of the patient's general condition may affect adherence to drug therapy. In the present study, anhedonia was assessed on the Snaith-Hamilton SHAPS scale, anxiety-depressive manifestations using the HADS hospital anxiety and depression scale and quality of life according to the SF-36 questionnaire during 24 weeks of follow-up.The result of drug therapy with Vortioxetine was the relief of affective disorders in alcohol dependence, which contributed to the improvement of overall subjective well-being, the degree of satisfaction with the quality of life and a decrease in anxiety-depressive tendencies and anhedonia. In addition, minimal and minor adverse reactions when taking Vortioxetine affected the increased adherence of the examined patients to medical prescriptions and recommendations.Conclusions. The use of Vortioxetine in the treatment of affective disorders among patients suffering from alcohol dependence provides new opportunities to help people suffering from alcohol addiction. Vortioxetine can be recommended both at the stage of inpatient care and outpatient treatment, since when it was taken, stable positive dynamics of antidepressant, anti-anxiety and antiangedonic effects were recorded.