Diagnosis Of Alcohol Dependence Research Articles

Relationship Between Alcohol Dependence and Neuropeptide Y (NPY) Gene Promoter Polymorphisms in A Turkish Sample

Neuropeptide Y (NPY) is a protein widely expressed in the central nervous system and involved in diverse physiological processes, such as emotional regulation, nutritional behavior, and stress. In some populations, studies on alcohol dependence (AD) and the NPY gene have found that NPY variations increase alcohol consumption and thus may potentially be associated with AD. In this study, we investigated the relationship between NPY gene promoter polymorphisms and phenotypes related to alcohol use. A total of 417 male participants comprising 252 individuals with AD and 165 healthy individuals were included in this study and phenotypic data were collected. Polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) and DNA sequencing METHODS were used for genotyping the rs16147 and rs17149106 polymorphisms in the promoter region of the NPY gene. The data of 384 participants were analysed to evaluate the possible relationship between genotypes and the diagnosis of AD, family history of AD, the severity of AD using the Michigan Alcoholism Screening Test (MAST), the age of onset of problematic alcohol use, the average amount of alcohol consumed per day for the last six months and the lifetime maximum alcohol consumption in one day. A significant difference was found between the AD and control groups concerning rs16147 polymorphism genotype distribution (p=0.025). No association with polymorphisms and alcohol-related phenotypes were demonstrated in the AD group. To our knowledge, this study shows for the first time in the literature that alcohol dependence is associated with NPY rs16147 polymorphism in the Turkish population.

THE TESTOSTERONE-CORTISOL MODEL AS A WAY TO UNDERSTAND THE MECHANISM OF ALCOHOL DEPENDENCE WHICH STARTED IN PUBERTY

The aim: Is to analyze the role of testosterone and cortisol in the mechanism of alcohol use disorders formation for further development of early diagnosis and prevention methods. Materials and methods: 155 adolescents at the preclinical stages of alcohol use disorders formation and 87 young patients with diagnosed alcohol dependence were studied by enzyme-linked immunoassay techniques. Results: The analysis of the obtained materials shows that the onset of search behaviors on alcohol consumption, frequency and alcohol abuse in adolescents occur with the participation of age-related processes of somatic puberty and the related syndromes of hormonal tension. The phasing of development and course of alcoholic disease includes pubertal age and alcohol-induced changes in the internal environment of the body. There is an increase in the concentration of testosterone and cortisol that initiates interest in alcohol first, and then under the influence of its toxic effect, the level of these hormones decreases. It should be borne in mind that significant differences in hormone concentrations were observed within the regulatory framework. Conclusions: An increase of testosterone and cortisol levels in puberty, combined with regular consumption of alcohol, may indicate a risk of addiction early. Further decrease of the levels of these hormones along with an increase of the frequency of alcohol consumption may be an early diagnostic feature of the alcohol use disorders.

Clinical and electrophysiological parameters of alcohol dependence and its comorbidity with affective disorders

To identify characteristics of and possible differences in clinical and electroencephalographic parameters in patients with alcohol dependence with- and without comorbid affective disorders. Ninety-five patients, including 74 with an established diagnosis of alcohol dependence and 21 with alcohol dependence and affective disorders, were examined. Duration of alcohol dependence and affective disorder (years), number of hospitalizations and suicidal attempts were analyzed as anamnestic data. Hamilton's anxiety and depression scale (HDRS), the Alcohol Use Disorders Identification Test (AUDIT), the General clinical impression scale (CGI-s) were used as psychometric tools. The study of bioelectric activity of the brain was carried out using a 16-channel encephalograph. The background electroencephalogram was recorded, the values of absolute spectral power and coherence of theta, alpha and beta rhythms were analyzed. Patients with comorbidity of alcohol dependence and affective disorders have a significantly higher risk of suicidal behavior, a greater frequency of hospitalizations, higher levels of anxiety compared with patients without affective disorders. Electrophysiological data have shown that patients with comorbidity of alcohol dependence and affective disorders have higher values of spectral power of alpha-rhythm in all parts of the cerebral cortex (except for temporal lobes) and beta-rhythm in the occipital cortex, as well as an increase in interhemispheric coherence in all frequency ranges.

M.P. Mussorgsky: interrelation of creativity and alcoholism

The article is devoted to the study of the circumstances of life, illness and creativity of the famous composer Modest Mussorgsky in aspects of possible influence of alcohol intake. For the purpose of retrospective diagnosis of alcohol dependence, and also for assessing the possibility of its impact on the composer's creativity, a pathographic analysis of publications about Modest Mussorgsky health throughout his life was carried out. A study of the letters of M.P. Mussorgsky, the memoirs of his contemporaries, the works of the composer's biographers, as well as the analytical studies of specialists in retrospective diagnostics showed that alcohol dependence negatively affected his creative activity. However, despite the progressive, clearly malignant course of alcohol dependence, the composer's professional skills evolved until the last days of his life. It is no less significant that in the most unfavorable periods of life, the composer wrote his most significant works. Often, Mussorgsky's music in its positive emotional content contrasts sharply with the grim realities of his life. There is no doubt that the composer's work was his only effective means of combating both alcohol addiction and life's hardships.

Clinical risk factors in SUDEP: A nationwide population-based case-control study.

ObjectiveWe conducted a nationwide case-control study in Sweden to test the hypothesis that specific clinical characteristics are associated with increased risk of sudden unexpected death in epilepsy (SUDEP).MethodsThe study included 255 SUDEP cases (definite and probable) and 1,148 matched controls. Clinical information was obtained from medical records and the National Patient Register. The association between SUDEP and potential risk factors was assessed by odds ratios (ORs) and 95% confidence intervals (CIs) and interaction assessed by attributable proportion due to interaction (AP).ResultsExperiencing generalized tonic-clonic seizures (GTCS) during the preceding year was associated with a 27-fold increased risk (OR 26.81, 95% CI 14.86–48.38), whereas no excess risk was seen in those with exclusively non-GTCS seizures (OR 1.15, 95% CI 0.54–48.38). The presence of nocturnal GTCS during the last year of observation was associated with a 15-fold risk (OR 15.31, 95% CI 9.57–24.47). Living alone was associated with a 5-fold increased risk of SUDEP (OR 5.01, 95% CI 2.93–8.57) and interaction analysis showed that the combination of not sharing a bedroom and having GTCS conferred an OR of 67.10 (95% CI 29.66–151.88), with AP estimated at 0.69 (CI 0.53–0.85). Among comorbid diseases, a previous diagnosis of substance abuse or alcohol dependence was associated with excess risk of SUDEP.ConclusionsIndividuals with GTCS who sleep alone have a dramatically increased SUDEP risk. Our results indicate that 69% of SUDEP cases in patients who have GTCS and live alone could be prevented if the patients were not unattended at night or were free from GTCS.

Genetic features of the dopaminergic neurotransmitter system in patients with alcohol dependence and depression comorbidity

Aim. Test the hypothesis about the effect of polymorphisms of the DA system on the risk of developing depression in patients with alcohol dependence. Material and methods. 104 patients: 64 patients with a combination of diagnoses of “alcohol dependence” and “depression” (F10.2 and F32, F33 according to ICD-10, average age 41.23 ± 9.903 years) and 40 patients with a diagnosis of alcohol dependence (F10 .2 according to ICD-10, average age 45.57 ± 10.853 years) and 113 control (average age 43.65 ± 4.318 years). Results. In patients with a combination of AD and depression, the frequency of occurrence of the C allele C polymorphism rs1611115 of the DBH gene is higher than in the control group (p = 0.087, trend). In patients with a combination of AD and depression, the frequency of occurrence of the A allele of the rs1108580 polymorphism of the DBH gene is higher than in patients with AD (p = 0.059, trend). In patients with AD allele A, the DBH gene rs1108580 polymorphism increases the risk of depression by 174.0% (p = 0.009), the DBH gene rs1108580 AA polymorphism increases the risk of depression by 684.1% (p = 0.010), the rs1108580 gene AG polymorphism rs1108580 in the gene DBH increases the risk of depression by 261.1% (p = 0.010). Conclusion. It has been shown for the first time that polymorphic variants of the rs1108580 locus of the DBH gene act as important risk factors for depression in patients with AD. Polymorphism rs1611115 of the DBH gene can also play an important role in the development of depression in patients with AD, which requires further study.

P.285 The substance use intervention team: Preliminary analysis of a population-level strategy addressing the opioid crisis at an academic medical center

This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture (EA) among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms (PAWS).A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to an escitalopram with real-EA group (real-EA group, patients= 31) and an escitalopram with sham-EA group (sham-EA group, patients= 31), respectively. In addition to the oral administration of escitalopram for total four weeks, patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks. Both serum homocysteine (Hcy) test and electrophysiological tests, including event-related potentials (ERPs) and exploratory eye movement (EEM) were performed at pre- and post-treatment. Additionally, the global scores of Penn Alcohol Craving Scale (PACS), 17-items Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA) were used for assessing the subjective emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.After four-week treatment, the global scores of PACS and HAMD-17 declined significantly in both groups (both P<0.05). Furthermore, the decline in the real-EA group was superior to that in the sham-EA group (P<0.05). Meanwhile, the total scores of HAMA only decreased in the real-EA group (P<0.05) but not in the sham-EA group (P>0.05). According to the parameters of ERPs, significant declines for N2PL, P3PL, and P3amp were observed in both two groups (all P<0.05), and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group (both P<0.05). According to the parameters of EEM, significant increase for NEF was observed only in the real-EA group (P<0.05). Besides, there was a dramatic decline for serum Hcy level only in the real-EA group (P<0.05). One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste, and outcomes of the remaining 61 patients were adopted for analysis.(1) Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence. (2) Escitalopram with EA might improve the alcohol-dependence induced cognitive dysfunctions via upregulating the expression of Hcy.

Self-perceived competencies in the diagnosis and treatment of mental health disorders among general practitioners in Lima, Peru

AimTo assess the self-perceived competencies in diagnosing and treating patients with mental health disorders, among recently graduated general practitioners (GPs) from Lima, Peru.MethodsA cross-sectional study was performed in April 2017 at a General Practitioner’s meeting held for those who were going to perform the social service, by the Peruvian College of Physicians in Lima. Attendees were invited to answer a questionnaire that evaluated their self-perception of competence in diagnosing and treating four different mental health disorders; major depression, anxiety disorder, alcohol dependence, and schizophrenia.ResultsOut of 434 evaluated GPs, the following percentages were self-perceived as competent in their adequate diagnosis of depression (70.5%), anxiety (73.3%), alcohol dependence (67.6%), and schizophrenia (62.0%). Concerning pharmacological treatment, these percentages were 46.6, 47.5, 39.0 and 37.6%, respectively. Referring to all the studied mental disorders, 41.6% of participants self-perceived competence in providing an adequate diagnosis, 36.1% in providing non-pharmacological treatment, and 20.1% in providing pharmacological treatment.ConclusionThe rate of adequate self-perceived competences was higher for diagnosis than for treatment of patients with mental health disorders. These results highlight the importance of designing and implementing interventions to improve medical education so as to develop the skills necessary to confront mental health disorders.

Childhood maltreatment, cognitive emotion regulation strategies, and alcohol craving and dependence in alcohol-dependent males: Direct and indirect pathways

ObjectivesChildhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence. MethodsIn a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II). ResultsParticipants with alcohol dependence had early age of onset of alcohol use (mean = 20.78 years), relatively long duration of alcohol use (mean = 11.14 years), and low education (mean = 9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence. ConclusionsAlthough drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.

Associations between self-rated health, quality of life and symptoms of depression among Finnish inpatients with alcohol and substance use disorders

ABSTRACTBackground: Alcohol and substance use disorders (SUDs) are known to be associated with various health problems and somatic comorbidities however, not much is known on how individuals with SUDs themselves view their own health. Depression is common in SUDs and it is also associated with various health problems. The aim of this study was to assess how individuals undergoing inpatient treatment for SUDs perceived their health status and quality of life (QoL) and how having symptoms of depression affected these perceptions.Methods: Data regarding a convenience sample of eighty inpatients with a diagnosis of alcohol or substance dependence were analyzed. Data were collected through a clinical interview and validated questionnaires.Results: Individuals undergoing inpatient treatment for SUDs reported various somatic comorbidities and their self-rated health was moderate. Back pain, high blood pressure and liver disease were the most commonly reported somatic comorbidities. More severe symptoms of depression were associated with poorer self-rated health, more comorbidities and poorer QoL after adjusting for potential confounders such as age.Conclusions: Individuals with SUDs have many health-related concerns and their QoL is impaired. Symptoms of depression are associated with self-rated health and QoL in this population.

Psychometric properties of the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) in alcohol-dependent individuals

Positive and negative metacognitions regarding alcohol effects are related to drinking problems. This study aimed to validate the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) and to assess the relations of metacognitions about alcohol use to alcohol craving and dependence in a clinical sample of males with a DSM diagnosis of alcohol dependence. Three hundred treatment-seeking males with alcohol dependence completed the Alcohol Use Disorders Identification Test (AUDIT), the Alcohol Outcome Expectancy Questionnaire (AOEQ), the Obsessive Compulsive Drinking Scale (OCDS), the Depression Anxiety Stress Scales (DASS-21), and the Persian-translated versions of the PAMS and NAMS. The results showed that similar to original versions of the PAMS and NAMS, the Persian version of the scales had a two-factor structure. Test-retest coefficients over a four-week interval and internal consistency showed good reliability for the Persian-PAMS and Persian-NAMS and their subscales. Predictive validity showed that positive metacognitions about alcohol use were associated with alcohol craving and dependence independent of outcome expectancies about alcohol use. The findings suggest that the Persian-PAMS and Persian-NAMS have appropriate psychometric properties in Iranian males with alcohol dependence. Results also highlight that positive metacognitions may be more related to alcohol craving and dependence relative to outcome expectancies about alcohol use.

Predictors of substance use treatment initiation and engagement among adult and adolescent Medicaid recipients

Background: It is important to understand patterns and predictors of initiation and engagement in treatment for Medicaid-covered individuals with substance use disorders because Medicaid is a major source of payment for addiction treatment in the United States. Our analysis examined similarities and differences in predictors between adults and adolescents. Methods: An analysis of Oregon Medicaid claims data for the time period January 2010 through June 2015 assessed rates of substance use and of treatment initiation and engagement using the Healthcare Effectiveness Data and Information Set (HEDIS) definitions. The analysis included individuals aged 13–64 with a new alcohol and other drug dependence diagnosis who met the HEDIS enrollment criteria and did not have cancer. We created 4 logistic regression models to assess treatment initiation and engagement, separately for adults (ages 18–64) and adolescents (ages 13–17). Independent predictors included age, gender, race, the interaction of gender and race, urban/rural residence, presence of any chronic disease, a psychiatric diagnosis, or a pain diagnosis. Results: Among adults, odds of initiation were lower in white males than in nonwhite males, white females, and nonwhite females. Conversely, among adolescents, odds of initiation were higher in white males than in the other gender/race groups. Predictors of initiation also went in opposite directions for presence of a psychiatric diagnosis (negative in adults, positive in adolescents) and urban residence (positive in adults, negative in adolescents). We found similar patterns in models of engagement, although for engagement those with a psychiatric diagnosis had lower odds of engagement in both adults and adolescents. Conclusions: Predictors of treatment initiation and engagement for alcohol and drug use disorders differed between adults and adolescents on Medicaid. A better understanding of these differences will enable development of targeted treatment programs that are effective within age groups.

The Prescription of Anticraving Medication and its Economic Consequences

Importance: According to recent studies, only a small proportion of alcoholics in the system for addiction treatment receive expedited treatment [Rehm et al.: Sucht 2014;60:93–105] and that those who are untreated are at risk of harmful and dependent alcohol consumption. This is associated with significantly negative effects on morbidity, mortality, and quality of life [Kraus et al.: Sucht 2010;56:337–347]. As a result, not only individuals and their environment suffer but there is also a health economic impact. Objective: How often do patients with a primary or secondary diagnosis of alcohol dependence who have been discharged from inpatient treatment receive anticraving medication in the follow-up period of 6 months? Design, Setting, and Participants: Based on data from a statutory health insurance in Germany, 12,958 patients were investigated regarding alcohol dependence, rates for readmission to hospital, and prescription of anticraving drugs. In addition, outpatient and inpatient treatment costs were calculated. Main Outcomes and Measures: There will be an examination of how often anticraving medications are prescribed and what the economic consequences are. Results: Two hundred and eighty-eight (2.22%) patients received anticraving medication, 98 (0.76%) in the first 6 months after inpatient treatment. Fifty-nine of the 288 patients were monitored with a pre- and postcomparison over a 90-day period. Inpatient treatment fell from 0.83 times (±1.10) during the 3 months afterward to 0.79 (±1.01). On average, the duration of an inpatient stay before anticraving treatment (n = 29) was 17.34 days (±14.37), with an average cost of EUR 4,142.70 (±2,721.28). Among the anticraving treatment group, this fell to 14.03 days (±9.96) with an average cost of EUR 3,685.43 (±2,307.67). Overall, the average outpatient and inpatient treatment costs dropped from EUR 1,533.88 before treatment to EUR 1,462.76 after treatment. If this is extrapolated to the whole group, it leads to between EUR 921,500 and EUR 6.6 million saving for a health insurance company. Conclusion: Anticraving medications are hardly ever prescribed. Their routine use could reduce hospital readmission rates and save on health-care costs.

The Family Check-up Intervention Moderates Polygenic Influences on Long-Term Alcohol Outcomes: Results from a Randomized Intervention Trial.

Alcohol problems are influenced by both genetic and environmental factors. Evidence from twin models and measured gene-environment interaction studies has demonstrated that the importance of genetic influences changes as a function of the environment. Research has also shown that family-centered interventions may protect genetically susceptible youth from developing substance use problems. In this study, we brought large-scale gene identification findings into an intervention study to examine gene-by-intervention effects. Using genome-wide polygenic scores derived from an independent genome-wide association study of adult alcohol dependence, we examined whether an adolescent family-centered intervention would moderate the effect of genetic risk for alcohol dependence on lifetime alcohol dependence in young adulthood, approximately 15years after the start of intervention, among European American (N = 271; 48.3% in the intervention condition) and African American individuals (N = 192; 51.6% in the intervention condition). We found that among European American individuals, the intervention moderated the association between alcohol dependence polygenic scores and lifetime alcohol dependence diagnosis in young adulthood. Among participants in the control condition, higher alcohol dependence polygenic scores were associated with a greater likelihood of receiving an alcohol dependence diagnosis; in contrast, among participants in the intervention condition, there was no association between alcohol dependence polygenic scores and alcohol dependence diagnosis. No moderation effect was found among African Americans. These results demonstrate that modifying environments of genetically vulnerable youth could reduce the likelihood of developing alcohol dependence and underscore the significance of environmentally focused prevention and intervention efforts.

Outcome in Relation to Drinking Goals in Alcohol-Dependent Individuals: A Follow-up Study 2.5 and 5 Years After Treatment Entry.

To evaluate the long-term treatment outcome (up to 5 years) with respect to different drinking goals of patients. Alcohol-dependent individuals (n = 349) were recruited from three alcohol treatment units. They were interviewed using the Addiction Severity Index (ASI). They were sub-grouped according to their goal at treatment entry: abstinence, low- risk drinking and no decided goal. Patients with abstinence as a goal at treatment entry reported at 2.5 years follow-up a higher abstinence rate, a more pronounced reduction in alcohol consumption, reduction in total number of DSM-IV criteria, higher frequency of low-risk drinking and fewer diagnoses of alcohol dependence compared to the groups who had low risk drinking as a goal or no decided goal. This improvement remained basically unchanged in all three groups at 5 years follow-up, suggesting long-term stability after the treatment interventions. The findings suggest that: (1) alcohol-dependent patients who have abstinence as their own drinking goal have a more favorable treatment outcome than those who have low-risk drinking as a goal or no decided goal. (2) Abstinence as a drinking goal should be considered for those who have a longer duration (for example more than 10 years) of their alcohol-related problems. (3) Patients who have no decided goal should be recommended abstinence as a drinking goal.

Alcohol Craving Predicts Relapse After Residential Addiction Treatment.

Replicate the previously reported association of elevated alcohol craving, measured by Penn Alcohol Craving Scale (PACS) during residential treatment, with post-treatment relapse and explore whether elevated craving scores 3 months post-treatment are also associated with subsequent relapse. Alcohol craving was assessed with the PACS on admission and at several time points post-treatment in 190 subjects with DSM-IV diagnosis of alcohol dependence admitted to residential treatment. Data about relapse to any drinking (primary outcome measure) was collected at 3, 6, 9 and 12 months after treatment. Cox regression models were used to determine whether PACS scores were associated with relapse. Statistical models were adjusted for meaningful demographic and clinical covariates. Follow-up data was available for 149/190 (78%) of subjects. Elevated PACS scores at discharge were associated with increased relapse risk within the first 3 and 12 months after discharge (P = 0.032 and P = 0.045, respectively). Elevated PACS scores at 3 months were associated with increased risk of subsequent relapse within 12 months after treatment in contacted subjects (P = 0.034) and in the intent-to-treat analysis (P = 0.0001). Our findings indicate strong association of post-treatment relapse with elevated alcohol craving measured at treatment completion and at 3 months after treatment and justify the use of this measure to guide relapse-prevention efforts.

Effect of intranasal oxytocin on alcohol withdrawal syndrome: A randomized placebo-controlled double-blind clinical trial

BackgroundIn a pilot study, intranasal oxytocin was demonstrated to reduce the benzodiazepine dose needed to relieve withdrawal symptoms during alcohol detoxification. The aim of the present study was to compare the effect of oxytocin and placebo during a three-day period of alcohol detoxification at an addiction treatment center in Norway. MethodsRandomized, double-blind, placebo-controlled trial with 40 patients fulfilling criteria for ICD-10 diagnosis of alcohol dependence (F10.2), admitted for alcohol detoxification and withdrawal treatment. The benzodiazepine oxazepam was given as symptom-triggered treatment based on the scores of the Clinical Institute Withdrawal Assessment for Alcohol revised (CIWA-Ar) scale. Participants were randomized to receive either intranasal oxytocin (24 IU twice daily) or placebo. Primary outcome: Oxazepam dose required to complete a three-day course of detoxification. Secondary outcomes: Scores of the CIWA-Ar, the 10-item Hopkins Symptom Check List (HSCL-10), and self-reported total number of hours of sleep. ResultsThe mean total oxazepam dose (± standard deviation) was 56.8 ± 72.8 mg in the oxytocin group and 79.0 ± 122.9 in the placebo group (p = 0.490; difference -22.3 mg; 95% confidence interval (CI) -86.9 to +42.4 mg). The findings were inconclusive as to whether a difference in the CIWA-Ar score (5.94 ± 3.86 vs. 6.48 ± 3.92; p = 0.665) or in any of the other secondary outcomes was present. No serious adverse events were reported. ConclusionCompared to placebo, intranasal oxytocin did not significantly reduce the oxazepam dose needed to complete a 3-day course of alcohol detoxification and withdrawal treatment.

Randomized Control Trial of Culturally Adapted Cognitive Processing Therapy for PTSD Substance Misuse and HIV Sexual Risk Behavior for Native American Women

An overlooked sequela of HIV risk is trauma exposure, yet few HIV interventions address trauma exposure, mental health, and substance misuse. In a two-arm randomized controlled trial 73 Native American women were randomized to a culturally-adapted Cognitive Processing Therapy (CPT) or 6-weeks waitlist. Outcomes assessed: PTSD symptom severity, alcohol use frequency, substance abuse or dependence diagnosis, and high-risk sexual behavior defined as vaginal/anal intercourse (a) under the influence of alcohol and/or illicit substances, (b) with a partner who was concurrently sexually active with someone else, and/or (c) with more than one partner in the past 6 weeks. Among immediate intervention participants, compared to waitlist participants, there were large reductions in PTSD symptom severity, high-risk sexual behavior, and a medium-to-large reduction in the frequency of alcohol use. CPT appears to improve mental health and risk behaviors, suggesting that addressing PTSD may be one way of improving HIV-risk related outcomes.

Effects of CYP2D6 genetic polymorphisms on the efficacy and safety of fluvoxamine in patients with depressive disorder and alcohol use disorder

This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture (EA) among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms (PAWS).A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to an escitalopram with real-EA group (real-EA group, patients= 31) and an escitalopram with sham-EA group (sham-EA group, patients= 31), respectively. In addition to the oral administration of escitalopram for total four weeks, patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks. Both serum homocysteine (Hcy) test and electrophysiological tests, including event-related potentials (ERPs) and exploratory eye movement (EEM) were performed at pre- and post-treatment. Additionally, the global scores of Penn Alcohol Craving Scale (PACS), 17-items Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA) were used for assessing the subjective emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.After four-week treatment, the global scores of PACS and HAMD-17 declined significantly in both groups (both P<0.05). Furthermore, the decline in the real-EA group was superior to that in the sham-EA group (P<0.05). Meanwhile, the total scores of HAMA only decreased in the real-EA group (P<0.05) but not in the sham-EA group (P>0.05). According to the parameters of ERPs, significant declines for N2PL, P3PL, and P3amp were observed in both two groups (all P<0.05), and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group (both P<0.05). According to the parameters of EEM, significant increase for NEF was observed only in the real-EA group (P<0.05). Besides, there was a dramatic decline for serum Hcy level only in the real-EA group (P<0.05). One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste, and outcomes of the remaining 61 patients were adopted for analysis.(1) Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence. (2) Escitalopram with EA might improve the alcohol-dependence induced cognitive dysfunctions via upregulating the expression of Hcy.

Long-acting injectable antipsychotics in a mental health unit: pre and post-treatment analysis

This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture (EA) among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms (PAWS).A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to an escitalopram with real-EA group (real-EA group, patients= 31) and an escitalopram with sham-EA group (sham-EA group, patients= 31), respectively. In addition to the oral administration of escitalopram for total four weeks, patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks. Both serum homocysteine (Hcy) test and electrophysiological tests, including event-related potentials (ERPs) and exploratory eye movement (EEM) were performed at pre- and post-treatment. Additionally, the global scores of Penn Alcohol Craving Scale (PACS), 17-items Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA) were used for assessing the subjective emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.After four-week treatment, the global scores of PACS and HAMD-17 declined significantly in both groups (both P<0.05). Furthermore, the decline in the real-EA group was superior to that in the sham-EA group (P<0.05). Meanwhile, the total scores of HAMA only decreased in the real-EA group (P<0.05) but not in the sham-EA group (P>0.05). According to the parameters of ERPs, significant declines for N2PL, P3PL, and P3amp were observed in both two groups (all P<0.05), and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group (both P<0.05). According to the parameters of EEM, significant increase for NEF was observed only in the real-EA group (P<0.05). Besides, there was a dramatic decline for serum Hcy level only in the real-EA group (P<0.05). One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste, and outcomes of the remaining 61 patients were adopted for analysis.(1) Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence. (2) Escitalopram with EA might improve the alcohol-dependence induced cognitive dysfunctions via upregulating the expression of Hcy.