Diagnosis Of Alcohol Dependence Research Articles

Potential Molecular Mechanisms of Alcohol Use Disorder with Non-Coding RNAs and Gut Microbiota for the Development of Superior Therapeutic Application.

Many investigations have evaluated the expression of noncoding RNAs (ncRNAs) as well as their related molecular functions and biological machineries in individuals with alcohol dependence. Alcohol dependence may be one of the most prevailing psychological disorders globally, and its pathogenesis is intricate and inadequately comprehended. There is substantial evidence indicating significant links between multiple genetic factors and the development of alcohol dependence. In particular, the critical roles of ncRNAs have been emphasized in the pathology of mental illnesses, probably including alcohol dependence. In the comprehension of the action of ncRNAs and their machineries of modification, furthermore, they have emerged as therapeutic targets for a variety of psychiatric illnesses, including alcohol dependence. It is worth mentioning that the dysregulated expression of ncRNAs has been regularly detected in individuals with alcohol dependence. An in-depth knowledge of the roles of ncRNAs and m6A modification may be valuable for the development of a novel treatment against alcohol dependence. In general, a more profound understanding of the practical roles of ncRNAs might make important contributions to the precise diagnosis and/or actual management of alcohol dependence. Here, in this review, we mostly focused on up-to-date knowledge regarding alterations and/or modifications in the expression of ncRNAs in individuals with alcohol dependence. Then, we present prospects for future research and therapeutic applications with a novel concept of the engram system.

Mortality and alcohol-related morbidity in patients with delirium tremens, alcohol withdrawal state or alcohol dependence in Norway: A register-based prospective cohort study.

Little is known about long-term consequences of delirium tremens (DT). This study aimed to compare all-cause and cause-specific mortality and alcohol-related morbidity between patients with: (i) DT, (ii) alcohol withdrawal state (AWS) and (iii) alcohol dependence (AD). A national longitudinal health registry study with linked data from the Norwegian Patient Registry and the Norwegian Cause of Death Registry. Norway. All patients registered in the Norwegian Patient Registry between 2009 and 2015 with a diagnosis of AD (ICD-10 code F10.2), AWS (F10.3) or DT (F10.4) and aged 20-79 years were included (n = 36 287). Patients were categorized into three mutually exclusive groups; those with DT diagnosis were categorized as DT patients regardless of whether or not they had received another alcohol use disorder diagnosis during the observation period or not. Outcome measures were: annual mortality rate, standardized mortality ratios (SMR) for all-cause and cause-specific mortality and proportion of alcohol-related morbidities which were registered in the period from 2years before to 1year after the index diagnosis. DT patients had higher annual mortality rate (8.0%) than AWS (5.0%) and AD (3.6%) patients, respectively. DT patients had higher mortality [SMR = 9.8, 95% confidence interval (CI) = 8.9-10.7] than AD patients (SMR = 7.0, 95% CI = 6.8-7.2) and AWS patients (SMR = 7.8, 95% CI = 7.2-8.4). SMR was particularly elevated for unnatural causes of death, and more so for DT patients (SMR = 26.9, 95% CI = 21.7-33.4) than for AD patients (SMR = 15.2, 95% CI = 14.2-16.3) or AWS patients (SMR = 20.1, 95% CI = 16.9-23.9). For all comorbidities, we observed a higher proportion among DT patients than among AWS or AD patients (P < 0.001). People treated for delirium tremens appear to have higher rates of mortality and comorbidity than people with other alcohol use disorders.

Factors associated with not ready to stop using substances among adults with an unmet treatment need: findings from the National Survey of Drug Use and Health 2015-2019

ABSTRACT Background: A better understanding of factors associated with not ready to stop using substances may inform provider engagement with clients who have an unmet treatment need. Objectives: This study explores how treatment barriers, the number of SUD symptoms, and types of substances used are associated with not ready to stop using substances among adults with an unmet treatment need. Methods: The data came from the 2015–2019 National Survey on Drug Use and Health. Eligible adults met DSM-IV criteria for substance abuse and dependence and reported an unmet need for treatment. Among our sample (N = 1,017), a majority self-identified as male (weighted 59.3%). We employed multivariable logistic regression to examine individual-level factors associated with not being ready to stop using substances. Results: About 38% of the respondents reported that they were not ready to stop using substances. Reporting access barriers (aOR = 0.44, 95% CI: 0.29, 0.68) and attitudinal barriers (aOR = 0.47, 95% CI: 0.28, 0.80) was associated with a lower odds of not ready to stop using. Each additional increase in SUD symptoms was associated with 23% higher odds of not being ready to stop using (aOR = 1.22, 95% CI: 1.12, 1.34). Having a diagnosis of alcohol and/or marijuana abuse or dependence was associated with higher odds of not being ready to stop using when compared to respondents without these diagnoses (aOR = 2.13, 95% CI: 1.33, 3.40; aOR = 1.82 95% CI: 1.11, 2.99). Conclusion: Not ready to stop using substances may be impacted by the type of SUD, number of SUD symptoms, and certain barriers like access and attitude to care.

Prevalence of alcohol dependence in Mongolia: a nationwide population-based, cross-sectional study

Alcohol-related problems are a major health issue in Mongolia and remain underdiagnosed. The nationwide population-based, cross-sectional study reported here was carried out between September and November 2013. It aimed to determine the prevalence of alcohol dependence among the general population using two instruments: the Alcohol Use Disorder Identification Test (AUDIT) and an International Classification of Diseases (ICD)-10 based clinical interview. The AUDIT test, developed by the World Health Organization, was adopted to screen a full spectrum of alcohol-related disorders. Participants identified as at high risk of alcohol dependence were referred to a clinical interview for diagnosis of alcohol dependence. The interview was designed using ICD-10 diagnostic criteria. The study consisted of 11746 participants from 79 clusters, age 18–64 years (n=11746, males 49.1%, females 50.8%, mean age 39.6 ± 12.5 years). 45.4% of the participants (n=5336) abstained from alcohol use, 39% were at low risk of alcohol dependence (n=4582), 9.2% were at moderate risk (n=1075), and 6.4% were at high risk (n=753). Among the participants, a total of 522 participants (4.4%) were diagnosed as having alcohol dependence through the clinical interview. Increased risk of alcohol dependence was associated with those who were men, divorced or widowed, living in rural regions, unemployed, and less educated. The study results suggest that the prevalence of alcohol dependence is 4.4% among the general population of Mongolia. Gender, marital status, geographical location, and education significantly influence alcohol dependence.

Prevalence and incidence of alcohol dependence: cross-sectional primary care analysis in Liverpool, UK

ObjectivesLiverpool has high prevalence of alcohol use disorders (AUDs) compared with the rest of the UK. Early identification and referral in primary care would improve treatment for people with AUD....

A novel technology of structural distance feature of Raman spectra and convolutional neural network for alcohol dependence diagnosis

Alcohol dependence is an addictive disease, which can lead to cancer, depression, and other problems. The current diagnostic methods of alcohol dependence are easily disturbed by patients' subjective consciousness, which could lead to wrong diagnoses. To solve this problem, this paper applies serum Raman spectra and a deep learning algorithm to the diagnosis of alcohol dependence and constructs an innovative diagnostic framework. We collected 228 serum samples for spectral analysis, including 119 alcohol-dependent patients and 109 controls. In this framework, spectra are firstly converted to two-dimensional spectrograms by clipping and stitching. Then, a calculating box extracts the distance features between spectral nonadjacent peaks on the spectrogram. Finally, the eigenvalues of each peak are used as pixels of artificial images and input into the ConvNeXt-T neural network model for classification. The sensitivity and specificity of the method are 81.82% and 100%. The results show that it is feasible to use Raman spectroscopy combined with a deep learning algorithm to diagnose alcohol dependence. Compared with directly using the ConvNeXt-T model, the distance feature performs better.

Associations of sex-related steroid hormones and proteins with alcohol dependence: A United Kingdom Biobank study

BackgroundSex-related steroid hormones and proteins may contribute to the sex differences in the characteristics and health consequences of alcohol use disorder. This study aimed to examine the associations between alcohol dependence (AD) and sex-related hormones/proteins using a population-based dataset. MethodsWe retrieved serum total testosterone (TT) and estradiol (TE2), sex hormone binding globulin (SHBG), and albumin levels along with clinical data from the UK Biobank. Hormone/protein levels were compared between AD (lifetime AD and/or related diagnoses; 2218 males; 682 females) and control (no aforementioned diagnoses and AUDIT<8; 198,058 males; 250,830 females) groups with sex-dependent linear regression models adjusting for age and body mass index. Moderation and mediation analyses were performed to test whether SHBG was a moderator and/or mediator between hormones and AD or current drinking. ResultsAD males had higher TT, TE2, and SHBG levels but lower bioavailable testosterone, bioavailable estradiol, and albumin levels than controls (padjusted<0.001). After adjusting for menopause, AD females had higher TT and lower albumin levels than controls (padjusted<0.001). These differences remained after accounting for current drinking frequency (p < 0.001). SHBG moderated TT’s effect on AD in males (pinteraction<0.001). SHBG was a positive mediator between TT and AD in both sexes and between TE2 and AD in males (p < 0.001), but a negative mediator between TT and current drinking in controls (both sexes) and AD males (p < 0.001). ConclusionsTestosterone and estradiol levels are altered in males and females with AD distinctly regardless of current drinking frequency. SHBG may play a critical role in these associations.

Baclofen for alcohol use disorder.

Baclofen for alcohol use disorder.

Serum metabolomics analysis in patients with alcohol dependence.

Alcohol dependence (AD) is a chronic recurrent mental disease caused by long-term drinking. It is one of the most prevalent public health problems. However, AD diagnosis lacks objective biomarkers. This study was aimed to shed some light on potential biomarkers of AD patients by investigating the serum metabolomics profiles of AD patients and the controls. Liquid chromatography-mass spectrometry (LC-MS) was used to detect the serum metabolites of 29 AD patients (AD) and 28 controls. Six samples were set aside as the validation set (Control: n = 3; AD group: n = 3), and the remaining were used as the training set (Control: n = 26; AD group: n = 25). Principal component analysis (PCA) and partial least squares discriminant analysis (PCA-DA) were performed to analyze the training set samples. The metabolic pathways were analyzed using the MetPA database. The signal pathways with pathway impact >0.2, value of p <0.05, and FDR < 0.05 were selected. From the screened pathways, the metabolites whose levels changed by at least 3-fold were screened. The metabolites with no numerical overlap in their concentrations in the AD and the control groups were screened out and verified with the validation set. The serum metabolomic profiles of the control and the AD groups were significantly different. We identified six significantly altered metabolic signal pathways, including protein digestion and absorption; alanine, aspartate, and glutamate metabolism; arginine biosynthesis; linoleic acid metabolism; butanoate metabolism; and GABAergic synapse. In these six signal pathways, the levels of 28 metabolites were found to be significantly altered. Of these, the alterations of 11 metabolites changed by at least 3-fold compared to the control group. Of these 11 metabolites, those with no numerical overlap in their concentrations between the AD and the control groups were GABA, 4-hydroxybutanoic acid, L-glutamic acid, citric acid and L-glutamine. The metabolite profile of the AD group was significantly different from that of the control group. GABA, 4-hydroxybutanoic acid, L-glutamic acid, citric acid, and L-glutamine could be used as potential diagnostic markers for AD.

All-cause and liver-related mortality risk factors in excessive drinkers: Analysis of data from the UK biobank.

High alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts of alcohol. We obtained information from the UK Biobank on approximately 500,000 participants aged 40-70 years at baseline assessment in 2006-2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported consuming ≥80 or ≥50 g/day, respectively, were used in survival analysis. Mortality hazard ratios for these excessive drinkers, compared to all other participants, were 2.02 (95% CI 1.89-2.17) for all causes, 1.89 (1.69-2.12) for any cancer, 1.87 (1.61-2.17) for any circulatory disease, and 9.40 (7.00-12.64) for any liver disease. Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake; diagnosed alcohol dependence, harmful use, or withdrawal syndrome; and current smoking at assessment. People with chronic excessive alcohol intake experience decreased average survival, but there is substantial variation in their mortality, with liver abnormality and alcohol dependence or other alcohol use disorders associated with a worse prognosis. Clinically, patients with these risk factors and high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality.

The effect of intranasal oxytocin on processing emotional stimuli during alcohol withdrawal: A randomized placebo-controlled double-blind clinical trial

Alcohol dependence is associated with difficulties in processing emotional stimuli, which can lead to interpersonal problems. The neuropeptide oxytocin has been shown to modulate the processing of emotional stimuli, however, oxytocin treatment has not yet been examined in patients with withdrawal symptoms during alcohol detoxification. The aim of the present study was to investigate the effect of oxytocin on the reading the mind in the eyes test (RMET), which indexes theory of mind ability, during a three-day period of alcohol detoxification at an addiction treatment centre in Norway. We performed a randomized, double-blind, placebo-controlled trial in 39 patients fulfilling criteria for ICD-10 diagnosis of alcohol dependence admitted for alcohol detoxification and withdrawal treatment. Participants were randomized to receive either intranasal oxytocin (24 IU) or placebo, twice daily for three days. We evaluated RMET performance on day 2 and day 3 of detoxification and differences in RMET scores between day 2 and day 3 of detoxification. Frequentist and Bayesian statistical inference suggested that oxytocin administration during alcohol withdrawal in alcohol-dependent patients did not improve RMET performance. However, exploratory analyses provided preliminary evidence that oxytocin might improve performance on the RMET negative emotion subscale (uncorrected p value = 0.038), and that oxytocin treatment might show the most promise for those with high levels of alcohol consumption (i.e., ≥20 alcohol units per day; uncorrected p value = 0.023). Moreover, alcohol consumption levels significantly predicted RMET performance on day 2, but not on day 3, of withdrawal.

Acceptance and use of web-based interventions for alcohol abstinence

EinleitungDie Prävalenzraten für Alkoholgebrauchsstörungen liegen in Deutschland bei ca. 6 %, alkoholabhängig sind ca. 3 %. Nur ca. 10 % der Patienten befinden sich in suchtmedizinischer Therapie. In der Früherkennung und -intervention besteht zudem eine deutliche Unterversorgung. Eine bislang nicht evaluierte Ergänzung zu bestehenden Interventionsangeboten ist der außerhalb der professionellen Suchthilfe von einer ehemaligen Betroffenen entwickelte Internetauftritt „Ohne Alkohol mit Nathalie“ (OAmN). Die vorliegende Pilotstudie hatte zum Ziel, herauszufinden, ob die Nutzer der OAmN-Angebote zu jenen zählen, die bisher vom Suchthilfesystem nicht erreicht werden konnten.MethodenInnerhalb von vier Wochen wurden Nutzer auf vier verschiedenen OAmN-Kanälen dazu aufgerufen, sich an einer anonymen Befragung zu beteiligen. Ein Link führte jeweils zu einem webbasierten Fragebogen. Dieser umfasste offene, geschlossene sowie Multiple-Choice-Fragen zum Konsummuster von Alkohol und bisherigen Therapiebemühungen.ErgebnisseVon 2022 Teilnehmern gaben 84,3 % (n = 1705) an, ein „Alkoholproblem“ zu haben oder es gehabt zu haben. Davon hatten 17,7 % (n = 302) die Diagnose einer Alkoholabhängigkeit und 21 % (n = 529) Therapieerfahrung. Sistiert hatten ihren Alkoholkonsum zum Zeitpunkt der Befragung 85,5 % (n = 1457) der Betroffenen. Die meisten davon (48,5 %, n = 705) mithilfe von OAmN. 97,5 % (n = 1662) waren während ihrer Konsumzeit berufstätig und haben aus eigener Sicht zu 34,3 % (n = 570) „sehr gut“, zu 43,2 % (n = 718) „gut“ funktioniert.DiskussionDie Pilotstudie zeigt, dass webbasierte Angebote wie OAmN Menschen erreichen können, die durch Angebote des etablierten Suchthilfesystems nicht erreicht werden, obwohl eine alkoholbezogene Störung vorliegt und eine Bereitschaft zur Verhaltensänderung im Hinblick auf den Alkoholkonsum besteht.Zusatzmaterial onlineDie Onlineversion dieses Beitrags (10.1007/s00115-022-01385-0) enthält einen zusätzlichen Fragebogen. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder

Although classic psychedelic medications have shown promise in the treatment of alcohol use disorder (AUD), the efficacy of psilocybin remains unknown. To evaluate whether 2 administrations of high-dose psilocybin improve the percentage of heavy drinking days in patients with AUD undergoing psychotherapy relative to outcomes observed with active placebo medication and psychotherapy. In this double-blind randomized clinical trial, participants were offered 12 weeks of manualized psychotherapy and were randomly assigned to receive psilocybin vs diphenhydramine during 2 day-long medication sessions at weeks 4 and 8. Outcomes were assessed over the 32-week double-blind period following the first dose of study medication. The study was conducted at 2 academic centers in the US. Participants were recruited from the community between March 12, 2014, and March 19, 2020. Adults aged 25 to 65 years with a DSM-IV diagnosis of alcohol dependence and at least 4 heavy drinking days during the 30 days prior to screening were included. Exclusion criteria included major psychiatric and drug use disorders, hallucinogen use, medical conditions that contraindicated the study medications, use of exclusionary medications, and current treatment for AUD. Study medications were psilocybin, 25 mg/70 kg, vs diphenhydramine, 50 mg (first session), and psilocybin, 25-40 mg/70 kg, vs diphenhydramine, 50-100 mg (second session). Psychotherapy included motivational enhancement therapy and cognitive behavioral therapy. The primary outcome was percentage of heavy drinking days, assessed using a timeline followback interview, contrasted between groups over the 32-week period following the first administration of study medication using multivariate repeated-measures analysis of variance. A total of 95 participants (mean [SD] age, 46 [12] years; 42 [44.2%] female) were randomized (49 to psilocybin and 46 to diphenhydramine). One participant (1.1%) was American Indian/Alaska Native, 3 (3.2%) were Asian, 4 (4.2%) were Black, 14 (14.7%) were Hispanic, and 75 (78.9%) were non-Hispanic White. Of the 95 randomized participants, 93 received at least 1 dose of study medication and were included in the primary outcome analysis. Percentage of heavy drinking days during the 32-week double-blind period was 9.7% for the psilocybin group and 23.6% for the diphenhydramine group, a mean difference of 13.9%; (95% CI, 3.0-24.7; F1,86 = 6.43; P = .01). Mean daily alcohol consumption (number of standard drinks per day) was also lower in the psilocybin group. There were no serious adverse events among participants who received psilocybin. Psilocybin administered in combination with psychotherapy produced robust decreases in percentage of heavy drinking days over and above those produced by active placebo and psychotherapy. These results provide support for further study of psilocybin-assisted treatment for AUD. ClinicalTrials.gov Identifier: NCT02061293.

Sex-specific incidences and risk profiles of suicide mortality in people with alcohol dependence in Taiwan.

Alcohol-related mental health burden and suicidality impose heavy burdens on global public health. This study measured the sex-specific incidence and risk profiles of suicide mortality in individuals with alcohol dependence in a non-western context. In this prospective cohort study, individuals with alcohol dependence who were enrollees in Taiwan's National Health Insurance Research database were followed-up over an almost 15-year period. Their data were linked to the national mortality registration database. Taiwan. In total, 278 345 patients with alcohol dependence were enrolled and followed-up from 1 January 2001 to 31 December 2016. We calculated the incidence and standardized mortality ratio (SMR) of suicide in the cohort and stratified the suicide methods by sex. Sex-specific risk profiles (based on demographic characteristics and physical and psychiatric comorbidities) were generated through Cox proportional hazards regression. The suicide rates of men and women were 173.5 and 158.9 per 100 000 person-years, respectively (P = 0.097). The SMR of suicide mortality was more than two times higher in women than in men (6.6 versus 15.0). Women and men adopted different suicide methods. A multivariable Cox proportional hazards regression with a time-varying model revealed that depressive disorder was a common risk factor for suicide in both men and women [adjusted hazard ratio (aHR) = 3.03, 95% confidence interval (CI) = 2.77-3.31 versus aHR = 5.46, 95% CI = 4.65-6.40]. For men, receiving a diagnosis of alcohol dependence between the ages of 25 and 44 years, being unemployed and having schizophrenia, drug-induced mental disorder or sleep disorder were risk factors for suicide. In Taiwan, the incidence of suicide in patients with alcohol dependence is substantially higher than that of the general population. The standardized mortality ratio of suicide in women with alcohol dependence is more than twice that of men with alcohol dependence.

Study Links Long-Term Cannabis Use, Cognitive Deficits

Study Links Long-Term Cannabis Use, Cognitive Deficits

Incidence of and risk factors for alcohol dependence in bipolar disorder: A population-based cohort and nested case-control study.

Although alcohol dependence is highly prevalent in patients with bipolar disorder, the causal relationship is not yet well-established. This study estimated the incidence of alcohol dependence in a nationwide bipolar disorder cohort and examined risk factors for alcohol dependence. Patients aged 15-65 years with consistent bipolar disorder who had their first psychiatric admission between 1999 and 2012 (n = 21,791) were enrolled from the National Health Insurance Research Database in Taiwan. We calculated the adjusted incidence rate ratio of alcohol dependence in the bipolar cohort relative to the general population after stratification by age and sex. In the nested case-control study, we included patients with incident alcohol dependence as cases and four age- and sex-matched controls for each case to analyze health care utilization, comorbidities and concomitant medications between them. We identified 1261 patients with bipolar disorder with incident alcohol dependence. Relative to the general population, the adjusted incidence rate ratio of alcohol dependence was 9.20 in the bipolar cohort. All adjusted incidence rate ratios were high across all age subgroups. Cases had higher psychiatric and nonpsychiatric health care utilization than did controls. Multivariate analysis revealed that cases tended to have cardiovascular disease, diabetes mellitus, chronic hepatic disease, pneumonia and delirium before alcohol dependence diagnosis. Cases had higher psychiatric comorbidities, namely drug-induced mental disorders, anxiety disorder, personality disorder, adjustment disorder and sleep disorder. The bipolar cohort had a higher incidence of alcohol dependence. We identified specific groups with a high risk of alcohol dependence. Additional strategies for early detection, treatment and intervention for alcohol dependence should be developed.

Severity of depressive symptomatology and socio-demographic characteristics of patients with alcoholism in the Republic of Dagestan depending on territorial patterns of residence

Introduction. Living in urban and rural areas can affect the risk of developing and the course of alcohol dependence and comorbid conditions. The aim of the work was to evaluate the degree of depressive symptoms and socio-demographic characteristics of patients with alcoholism in the Republic of Dagestan, depending on the territorial features of residence. Materials and methods. The study involved 104 patients aged 51.2±9.9 years (27 to 74 years), registered in the State Budgetary Institution «Republican narcological dispensary» of the Republic of Dagestan with a diagnosis of alcohol dependence. The patients were divided into 2 groups depending on the territorial features of their residence: 62 (59.6%) patients residing in urban areas and 42 (40.4%) residing in rural areas. In order to evaluate socio-demographic characteristics all patients were questioned. The degree of severity of depressive symptoms was assessed with the Beck scale. Results. Analysis of alcohol dependence characteristics revealed no differences between the groups (p&gt;0.05). The degree of depression was found to be more pronounced in patients living in rural areas than in those living in urban areas: mild depression was 7.3% and 29.0% (p&lt;0.05), moderate depression was 9.8% and 1.6% (p&lt;0.05), and severe depression was 39.0% and 25.8% (p&lt;0.05), respectively. The severity of depression correlated with the presence of work in patients (r=0.324; p&lt;0.001). Discussion. Alcohol consumption leads to a more severe manifestation of depression, contributing to physiological changes in the body. Conversely, depressed people are more prone to uncontrolled alcohol consumption, which in their subjective opinion alleviates psychosocial suffering. The connection between alcohol abuse and depressive symptoms is bidirectional, meaning that both of these disorders influence the development and course of the other and simultaneously exacerbate the risk of developing the other disorder. Conclusions. Alcohol-dependent individuals living in rural areas of the Republic of Dagestan are characterized by unemployment that correlates with anxiety-depressive symptoms, as well as a more severe degree of depression severity.

The rates and measurement of adherence to acamprosate in randomised controlled clinical trials: A systematic review.

The current research aims to systematically review the rates of adherence reported in randomised controlled clinical trials of acamprosate. It also sought to determine the reliability of the adherence monitoring and measurement methods used in these trials. The protocol for this review was pre-registered (PROSPERO: CRD42021230011). A search of the literature was conducted using OVID MEDLINE, Embase and PsycINFO from database inception to January 2021. Randomised controlled trials with a minimum sample size of 10 per treatment arm that compared the efficacy of acamprosate with placebo or other active medication in adults with a diagnosis of alcohol dependence were included. Data on rates of adherence, methods of measurement and monitoring of adherence was extracted from eligible studies independently in duplicate by two reviewers. A weighted mean adherence rate was calculated. The reliability of adherence monitoring methods was determined by calculating an adherence-assurance score based on the adherence monitoring method used. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Fifteen studies met the eligibility criteria involving 4,450 participants (2,480 participants in the placebo arms). A mean adherence rate of 88% (54.2-95.0%) was reported across studies that reported the percentage of medication taken. A mean adherence rate of 84.9% (56.4-91.3%) was reported for trials that reported the percentage of participants taking more than 80% of medication prescribed. There is low confidence in the methods used to monitor adherence with all clinical trials having a low adherence-assurance rating. Risk of bias was judged to be high for all included studies. Adherence to acamprosate in clinical trials can be poor with low confidence in the methods used to measure it. Adherence rates therefore might not be accurate, which has implications for determining the efficacy of acamprosate.

Genome-wide meta-analysis of alcohol use disorder in East Asians

Alcohol use disorder (AUD) is a leading cause of death and disability worldwide. Genome-wide association studies (GWAS) have identified ~30 AUD risk genes in European populations, but many fewer in East Asians. We conducted GWAS and genome-wide meta-analysis of AUD in 13,551 subjects with East Asian ancestry, using published summary data and newly genotyped data from five cohorts: (1) electronic health record (EHR)-diagnosed AUD in the Million Veteran Program (MVP) sample; (2) DSM-IV diagnosed alcohol dependence (AD) in a Han Chinese–GSA (array) cohort; (3) AD in a Han Chinese–Cyto (array) cohort; and (4) two AD Thai cohorts. The MVP and Thai samples included newly genotyped subjects from ongoing recruitment. In total, 2254 cases and 11,297 controls were analyzed. An AUD polygenic risk score was analyzed in an independent sample with 4464 East Asians (Genetic Epidemiology Research in Adult Health and Aging (GERA)). Phenotypes from survey data and ICD-9-CM diagnoses were tested for association with the AUD PRS. Two risk loci were detected: the well-known functional variant rs1229984 in ADH1B and rs3782886 in BRAP (near the ALDH2 gene locus) are the lead variants. AUD PRS was significantly associated with days per week of alcohol consumption (beta = 0.43, SE = 0.067, p = 2.47 × 10−10) and nominally associated with pack years of smoking (beta = 0.09, SE = 0.05, p = 4.52 × 10−2) and ever vs. never smoking (beta = 0.06, SE = 0.02, p = 1.14 × 10−2). This is the largest GWAS of AUD in East Asians to date. Building on previous findings, we were able to analyze pleiotropy, but did not identify any new risk regions, underscoring the importance of recruiting additional East Asian subjects for alcohol GWAS.

Implications of health conditions on rural soybean workers' quality of life.

to analyze the implications of health conditions on rural workers' quality of life in the context of soybean production. a cross-sectional study, with an intentional sample of 299 male rural workers. Data collection took place between October and December 2019. The following instruments were used: World Health Organization Quality Life-bref; Rural Workers' Living & Health Conditions questionnaire; International Physical Activity Questionnaire; Cut down, Annoyed, Guilty, and Eye-opener. They were analyzed via descriptive and inferential statistics, using bivariate (Mann-Whitney; Kruskal-Wallis) and multivariate tests (generalized additive models for location, scale and shape). the presence of a diagnosis of morbidity, alcohol dependence, occupational accidents and absenteeism implied a decrease in workers' quality of life scores. the existence of unfavorable health conditions has a negative impact on rural soybean workers' quality of life.