Disorders Identification Test Research Articles

The Acceptability and Feasibility of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking in India

Abstract The effectiveness of Brief Interventions (BIs) for hazardous drinking is well established. However the implementation of BIs at scale in LMICs such as India is rare, primarily due to human resource related barriers. This paper describes the testing of acceptability and feasibility, and the preliminary impact, of a mobile phone delivered BI in an uncontrolled treatment cohort and nested qualitative study. Consenting adult (≥18 years) participants with an Alcohol Use Disorder Identification Test (AUDIT) score between 8 to 15 were recruited from educational institutions, workplaces, and primary care settings. The TLFB (Time-Line Follow Back) was administered to participants at baseline and 3 months post recruitment. All participants received the BI through text messages or IVR (Interactive Voice Response) over eight weeks; and in-depth interviews (IDIs) were conducted with some participants. The mean pre and post outcomes were compared using paired t-test. Qualitative data was analysed using thematic analyses. 29 participants received the intervention and 16 (55%) completed the outcome assessments. Some key qualitative findings indicated the desire from participants for fewer messages and messages that did not require interaction; and more messages with motivational content and information on practical skills to reduce drinking. The percentage days abstinent (PDA) was significantly higher at follow up than baseline in all those who had completed the TLFB at baseline and follow up. Feasibility and acceptability testing is an important component of the intervention development process to ensure that the resulting intervention is suitable for the context.

Alcohol consumption and risky sexual behaviours: consistent patterns in France and South Korea

Abstract Background Despite the concurrent increase in harmful alcohol use and risky sexual behaviours associated with STIs and HIV/AIDS among young adults, their relationship remains inconsistent due to the inherent influence of sociodemographic and cultural factors on drinking and sexual practices. This study aims to examine the relationship between alcohol consumption and risky sexual behaviours and cross-validate this relationship in France and South Korea. Methods We conducted a cross-sectional survey among young adults aged 18 to 30 in France and in South Korea in 2023-2024 (n = 998; 489 in France, 509 in Korea). A spearman partial correlation and a z-test on Fisher-transformed correlation coefficients were used to determine the relationship between alcohol use and risky sexual behaviours, as well as the consistency of this relationship across both samples. Results After controlling for age, gender, occupation, education, and perceived socioeconomic status, a positive correlation was found between the age of alcohol initiation and the age at first sexual intercourse in both samples (r=.17 in France, r=.28 in Korea; p < 0.001). Alcohol Use Disorder Identification Test (AUDIT) score and the frequency of drunkenness showed positive correlations with the number of sexual partners (r=.19, r=.26 in France; r=.19, r=.23 in Korea; p < 0.001). These two alcohol use indicators were also correlated with the frequency of inconsistent condom use (r=.15, r=.12 in France; r=.06, r=.14 in Korea; p < 0.001). The Z test confirmed that there is no significant difference in all correlation coefficients between the French and Korean samples. (p > 0.05, 95% CI). Conclusions An integrated health intervention aimed at simultaneously addressing harmful alcohol use and risky sexual behaviours is warranted to prevent high prevalence of sexually transmitted infections among young adults. Key messages • Recent data support that alcohol use is associated with risky sexual behaviours among young adults. • This relationship is consistent regardless of different sociodemographic and cultural settings.

The Feasibility and Acceptability of a Clinical Pharmacist-delivered Intervention to Reduce Bothersome Health Symptoms from Polypharmacy and Alcohol Use and Communicate Risk among People with HIV: Pilot Study Protocol.

Among persons with HIV (PWH), unhealthy alcohol use and polypharmacy contribute to bothersome symptoms (e.g., fatigue, dizziness, memory loss). However, effective risk communication targeting these associations is challenging. The HIV and Alcohol Research center focused on Polypharmacy (HARP) is conducting a pilot study that will generate feasibility and acceptability data on a clinical pharmacist-delivered counseling intervention targeting the modification of unhealthy alcohol use and polypharmacy in PWH. Counseling is guided by the Information-Motivation-Behavioral Skills-Motivational Interviewing (IMB-MI) model. Herein, we describe the study protocol. This pilot uses a one-group pre-test/post-test design. We will recruit 50 participants from those who participated in the consented cohort of the Veterans Aging Cohort Study. Participants must be prescribed ≥ 5 long-term medications, have a self-reported Alcohol Use Disorders Identification Test score > 0, and be living with HIV. We will exclude those with moderate-severe alcohol use disorder as identified by an Alcohol Symptom Checklist score ≥ 4. Data are collected using three self-administered surveys (baseline, immediately after booster intervention, and 30-days post-intervention), two PEth blood tests (baseline, 30 days post-intervention), and medication data from the electronic health record (baseline). The intervention includes a 60-minute IMB-MI-based counseling session followed by a booster session 2 weeks later. Some participants will also be asked to participate in a qualitative interview to provide feedback on the intervention. The pilot investigates the impact of an intervention on alcohol consumption and the use of multiple medications among PWH, exploring how best to reduce bothersome symptoms, communicate risk, and support behavior change in this population.

AUDIT‐C shows reliability when used online in patient portals

The Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) is a validated screen, but until recently has not been evaluated in routine conditions for adult primary care patients. A new study has found that AUDIT‐C screens have “excellent” test‐retest reliability, which assesses the consistency of results when given at two different times. Excellent test‐retest reliability means that there are similar results across separate test administrations, and the study, supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), shows that the AUDIT‐C can be used reliably in adult primary care patients. The study, led by Claire B. Simon, M.D., of the University of Washington in Seattle, used electronic health record (EHR) data from Kaiser Permanente. For the study, more than 18,000 adult primary care patients completed two AUDIT‐C screens at 1 to 21 days apart as part of routine care in 2021. Screen results were reliable whether completed in person or online through patient portals. However, reliability was higher when the patient completed both screens using online patient portals, compared to completing both screens in the clinic or one in the clinic and one online. Therefore, completing two screens may be a better option than just doing one. The study, High test–retest reliability of the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) questionnaire completed by primary care patients in routine care, is published in the February 2024 issue of Alcohol, Clinical and Experimental Research. The researchers also found that reliability was lower for American Indian/Alaska Native (AI/AN) patients and multiracial patients.

Nutritional habits and eating attitude in university students during the last wave of COVID-19 in Spain

Emotional Eating is eating in response to negative emotional states, such as boredom, loneliness, or anxiety. For some young people, both food and alcohol are a source of pleasure in their social life. A cross-sectional study was conducted in 2022-23 in the Health Sciences Faculty. Mediterranean Diet Adherence Test, alcohol use disorders identification test (AUDIT), Emotional Eater Questionnaire (EEQ), Pittsburgh Sleep Quality Index, Yale Food Addiction, Perceived Stress Scale, and Anxiety Questionnaire STAI, were employed. Emotional eater (EE) regarding to no emotional eater (NEE) presented a mild food addiction, a significantly high intake of carbohydrates, fat, and alcohol. Energy intake is dependent on saturated fat, also they are not conscious of their intake of calories, had worse sleep quality, high perceived stress, and worse healthy eating index (HEI) due to their intake of sweets and soft drinks. The diet quality could be affected by the stress of the pandemic. The association of emotional eating with the intake of sweet foods and alcoholic drinks maybe is a remaining situation of COVID-19. We suppose that maladaptive eating behaviors have improved over time during this pandemic. Even though it is necessary to promote healthier eating among university students, it is also necessary to improve healthy habits.

Body mass index of 23 or greater is relevant to hepatic steatosis and fibrosis in patients with harmful alcohol use.

Steatotic liver disease, characterized by a combination of metabolic dysfunction, alcohol use, or specific etiologies, is a leading cause of chronic liver disease. However, the role of metabolic dysfunction in chronic liver disease with harmful alcohol use remains unclear. This study aimed to investigate factors associated with hepatic steatosis and fibrosis in patients with harmful alcohol use. Over a 2-year period, we registered patients with harmful alcohol use, defined by an Alcohol Use Disorders Identification Test score of 8 or higher. We retrospectively analyzed background information, blood test results, ultrasound-guided attenuation parameter (attenuation coefficient), and liver stiffness measurement. Hepatic steatosis was defined as attenuation coefficient ≥0.65dB/cm/MHz, and fibrosis as liver stiffness measurement ≥7.5kPa. The study included 131 patients (82% men, median age 59years). Linear regression analysis revealed significant associations with attenuation coefficient for body mass index ≥23 (0.08, p<0.0001) and age (-0.002, p=0.002). Liver stiffness measurement was associated with body mass index ≥23 (2.52, p=0.001), aspartate aminotransferase (0.02, p=0.0189), gamma-glutamyl transpeptidase (0.008, p<0.0001), platelet count (-0.02, p=0.001), and prothrombin international normalized ratio (26.40, p<0.0001). Among the four groups classified by the presence or absence of steatosis and fibrosis, patients with fibrosis, but without steatosis, demonstrated the lowest liver reserve. In contrast, patients with both steatosis and fibrosis showed higher aspartate aminotransferase and gamma-glutamyl transpeptidase levels. Body mass index is associated with both hepatic steatosis and fibrosis in patients with harmful alcohol use.

Combat readiness, alcohol abuse, and posttraumatic stress disorder among Uganda peoples’ defence forces soldiers

BackgroundThis cross-sectional study assessed combat readiness, alcohol abuse and post-traumatic stress disorder (PTSD) among Uganda Peoples’ Defense Forces (UPDF) soldiers returning from Operation Lightning Thunder (OLT) in South Sudan and Central African Republic.MethodsOne hundred fifty participants recruited from UPDF soldiers who had recently withdrawn from OLT, and were based in Singo Peace Support Operation School were screened for combat readiness, alcohol abuse and PTSD. The Perceived Combat Readiness Questionnaire, Alcohol Use Disorder Identification Test, and PTSD checklist military version were used to measure the variables. Inferential analyses were performed to determine the association between combat readiness, alcohol abuse, and PTSD, while controlling for sociodemographic factors.ResultsWe found that 16% of UPDF soldiers met positive screening results for PTSD, and 21% met the positive screening results for moderate substance use disorder. UPDF soldiers who benefited from combat readiness were less likely to develop PTSD or alcohol abuse. Our results showed a mediating effect of alcohol abuse on combat readiness and PTSD among soldiers with UPDF.ConclusionOur results highlight the high rates of PTSD and alcohol abuse among UPDF soldiers returning from military deployment. These findings provide insight into the role of combat readiness in reducing the risk of alcohol abuse and vulnerability to PTSD in the aftermath of military deployment.

Validation of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in Spanish University Students.

The aim of this study was to explore the factorial structure, psychometric properties and association with anthropometric and clinical variables of the Modified Yale Addiction Scale 2.0 (mYFAS 2.0) in a Spanish university population. A cross-sectional study of n = 270 university students in Spain was conducted. mYFAS 2.0, Emotional Eater Questionnaire (EEQ), Alcohol Use Disorder Identification Test (AUDIT), Pittsburg Sleep Quality index (PSQI) and Perceived Stress Scale (PSS). In mYFAS 2.0 were performed an Exploratory Factor Analysis (EFA), an Unweight Least Square (ULS), a model fit using comparative fit index (CFI) and nomological validity. EFA revealed that a two-factor structure is the most appropriate in a non-clinical population of Spanish university students. The factors accounted for 18.54% and 16.33% of the variance, and the correlation between them was moderate-0.487 (p < 0.001). This different structure from that reported in the original scale could be derived from the cultural characteristics and intrinsic eating habits of the study population. The correlation matrix reported an inverse association of mYFAS 2.0 with Body Mass Index (BMI). In addition, participants with a BMI below 25 showed a higher mYFAS 2.0 and EEQ score. These results suggest some changes in the psychometric assessment structure of the mYFAS 2.0 in a non-clinical population of university students, as well as the usefulness of this questionnaire to identify individuals with an adequate BMI but with compensatory behaviours that predispose to different eating disorders.

Exploring the relationship between sarcopenia and 11 respiratory diseases: a comprehensive mendelian randomization analysis

BackgroundSarcopenia (SP) is an aging-related loss of muscle mass and function, affecting the respiratory system. However, the causality of the association between sarcopenia on lung diseases remains elusive.MethodsThe bidirectional univariate Mendelian randomization (UVMR), multivariate MR (MVMR) analysis, and mediation MR were utilized to systematically investigate the genetic causal relationship of SP and 11 respiratory diseases. Independent genomic variants related to sarcopenia or respiratory diseases were identified as instrumental variables (IVs), and the summary level data of genome-wide associated studies (GWAS) were obtained from the UK biobank and FinnGen. MVMR analysis was conducted to explore the mediation effects of body mass index (BMI), Alcohol Use Disorders Identification Test (AUDIT), smoking, education attainment (EA), physical activity, and Type 2 Diabetes Mellitus (T2DM).ResultsForward UVMR analysis based on the primary method revealed that pneumoconiosis was associated with a higher risk of appendicular lean mass (ALM) (OR = 1.01, p = 0.03), and BMI (10.65%), smoking (10.65%), and physical activity (17.70%) had a mediating role in the effect of pneumoconiosis on ALM. In reverse MR analysis, we found that genetically predicted ALM was significantly associated with an increased risk of pulmonary embolism (PE) (OR = 1.24, p = 7.21E-05). Chronic obstructive pulmonary disease (COPD) (OR = 0.98, p = 0.002) and sarcoidosis (OR = 1.01, p = 0.004) were identified to increase the loss of left-hand grip strength (HGS). Conversely, the increase in left- HGS presented a protective effect on chronic bronchitis (CB) (OR = 0.35, p = 0.03), (OR = 0.80, p = 0.02), and asthma (OR = 0.78, p = 0.04). Similarly, the loss of the right-HGS elevated the risk of low respiratory tract infection (LRTI) (OR = 0.97, p = 0.02) and bronchiectasis (OR = 1.01, p = 0.03), which is also an independent protective factor for LRTI and asthma. In the aspects of low HGS, the risk of LRTI was increased after MVMR analysis, and the risk of sarcoidosis and pneumoconiosis was elevated in the reverse analysis. Lastly, asthma was found to be related to the loss of the usual walking pace, and the reverse MR analysis suggested a causal relationship between the usual walking pace and LRTI (OR = 0.32, p = 2.79 × 10−5), asthma (OR = 0.24, p = 2.09 × 10−6), COPD (OR = 0.22, p = 6.64 × 10−4), and PE(OR = 0.35, p = 0.03).ConclusionsThis data-driven MR analysis revealed SP was bidirectional causally associated with lung diseases, providing genetic evidence for further mechanistic and clinical studies to understand the crosstalk between SP and lung diseases.

Prevalence and long-term change in alcohol consumption: results from a population-based cohort in Southern India

BackgroundAlcohol consumption in India is below the global average, with limited data on long-term effects. The current study aims to examine changes over time among alcohol consumers, the pattern of drinking and help-seeking for alcohol problems among South Indian men.MethodData on the intake of various alcohol types were collected through standard questionnaires in two adult follow-ups [Baseline: 1998–2002, Follow-up: 2016–2019] from male participants in the Vellore birth cohort (VBC). Alcohol intake was converted to weekly standard drink units for analysis. Data on drinking patterns using the Alcohol Use Disorder Identification Test (AUDIT) and information on help-seeking among problem drinkers were collected during follow-up. Socio-demographic associations with alcohol consumption were determined using logistic regression.ResultsThe prevalence of alcohol consumption was 54.5% and 47.7% at the baseline and follow-up, respectively. Over two decades, 12% of men reported to have newly started drinking and 18% quit drinking. Lower education and lower socio-economic status (SES) were the strongest predictors of alcohol consumption. The AUDIT assessment among drinkers reported hazardous drinking of 38.4%, harmful drinking of 4.7% and 3.7% probable alcohol dependence. Among the persons with high AUDIT scores, 25% were concerned about high consumption, and 9% sought help to stop their alcohol consumption.ConclusionOur results showed a decline in alcohol consumption in this cohort over two decades. Among drinkers, a high proportion report hazardous and harmful consumption. Low levels of education and SES are significant predictors of alcohol consumption. A low proportion of help-seeking reflects alcohol-related stigma in the community.

The Gaming Disorder Identification Test (GADIT) - A screening tool for Gaming Disorder based on ICD-11.

Gaming Disorder was included as an addictive disorder in the latest version of the International Classification of Diseases (ICD-11), published in 2022. The present study aimed to develop a screening tool for Gaming Disorder, the Gaming Disorder Identification Test (GADIT), based on the four ICD-11 diagnostic criteria: impaired control, increasing priority, continued gaming despite harm, and functional impairment. We reviewed 297 questionnaire items from 48existing gaming addiction scales and selected 68 items based on content validity. Two datasets were collected: 1)an online panel (N = 803) from Australia, United States, United Kingdom andCanada, split into a development set (N = 589) and a validation dataset (N = 214); and 2) a university sample (N = 408) from Australia. Item response theory and confirmatory factor analyses were conducted to select eight items to form the GADIT. Validity was established by regressing theGADIT against known correlates of Gaming Disorder. Confirmatory factor analyses ofthe GADIT showed good model fit (RMSEA=<0.001-0.108; CFI = 0.98-1.00), and internal consistency was excellent (Cronbach's alphas = 0.77-0.92). GADIT scores were strongly associated with the Internet Gaming Disorder Test (IGDT-10), and significantly associated with gaming intensity, eye fatigue, hand pain, wrist pain, back or neck pain, and excessive in-game purchases, inboth the validation and the university sample datasets. The GADIT has strong psychometric properties in two independent samples from four English-speaking countries collected through different channels, and shown validity against existing scales and variables that are associated with Gaming Disorder. A cut-off of 5 is tentatively recommended for screening for Gaming Disorder.

Choice of alcohol over a natural reward: an experimental study in light and heavy social drinkers.

A core symptom of alcohol use disorder (AUD) is a progressively increased choice of alcohol over alternative rewards despite negative consequences. Here, we investigated choice between personalized alcohol vs. natural rewards in a laboratory setting, and compared this behavior between non-treatment-seeking heavy drinkers and light social drinkers. 30 light social drinkers (15 men drinking < 15 drinks/week and 15 women drinking < 10 drinks/week) and 30 heavy, non-treatment-seeking drinkers (drinking more than these levels; 15 women). In the Concurrent Choice Alcohol Food (CCAF) task, participants chose between individually tailored images of alcohol and snack rewards and collected points towards the respective reward. To assess cost sensitivity, points associated to the images varied so that they favored alcohol or snack, or were equal, creating three relative point levels. Choice preference for alcohol was strongly correlated with Alcohol Use Disorder Identification Test (AUDIT) scores, supporting the external validity of the choice procedure. Compared to light drinkers, heavy drinkers showed increased choice preference for alcohol, as indicated by a between-group difference in points of subjective equality, a metric that quantifies the relative point level at which alcohol and snacks were equally likely to be chosen. In both groups, choice preference strongly depended on the relative point level of alcohol compared to snacks, suggesting that responding for alcohol in heavy drinkers was sensitive to costs. Our results replicate previous findings of a relationship between self-reported alcohol use and choice preference for alcohol. We also found that choice behavior was strongly dependent on relative cost of alcohol in both groups, although price sensitivity was lower in heavy compared to light drinkers. An increased choice preference for alcohol in heavy drinkers suggests that they attribute a higher relative reinforcing value to alcohol compared to natural rewards.

Effectiveness of a Motivational Interviewing-Based Intervention in Decreasing Risky Alcohol Use in Primary Care Patients in Spain: A Controlled Clinical Trial

Objective: Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial. Methods: PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size. Results: A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37–27.99), with an NNT of 6 (95% CI: 4–19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73–24.24%), and the NNT was 8 (95% CI: 4–37). Conclusions: We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC.

Smoking-Related Increases in Alcohol Outcomes and Preliminary Evidence for the Protective Effect of a Functional Nicotine Receptor Gene (CHRNA5) Variant on Alcohol Consumption in Individuals Without Alcohol Use Disorder.

Alcohol and nicotine interact with the nicotinic acetylcholine receptor system to alter reward-related responses, thereby contributing to the co-use and misuse of these drugs. A missense polymorphism rs16969968 (G>A) in the CHRNA5 gene has shown a strong association with nicotine-related phenotypes. However, less is known about the impact of this variant on alcohol-related phenotypes. We assessed the main and interactive effect of smoking and rs16969968 polymorphism on alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT), Timeline Follow Back (TLFB), and Lifetime Drinking History (LDH) in 980 healthy adults without alcohol use disorder. We further examined the effect of the rs16969968 polymorphism on acute alcohol consumption using a free-access i.v. alcohol self-administration (IV-ASA) human laboratory paradigm in a subset of 153 nonsmoking participants. Subjective alcohol responses, alcohol sensitivity, and expectancy measures were compared between genotype groups (GG; AA/AG). We observed a significant association of smoking with AUDIT, TLFB, and LDH measures across genotype groups, with smokers showing higher scores compared with nonsmokers. Additionally, we found an association between genotype and TLFB-total drinks in the IV-ASA subset, with the GG group showing higher scores than AA/AG group. Relatedly, the alcohol negative expectancy score was significantly lower in the GG group than the AA/AG group. Our findings underscore the association of smoking with alcohol measures. We found preliminary evidence for the protective effect of the functional CHRNA5 polymorphism on alcohol consumption and its association with increased negative alcohol expectancies, which highlights the substantial heterogeneity in alcohol responses.

Serum BDNF and pro-BDNF levels in alcohol use disorders according to depression status: An exploratory study of their evolution two months after withdrawal

BackgroundAlcohol use disorders (AUDs) are complex pathologies with a myriad of molecular actors involved in both disease progression and remission. Brain-derived neurotrophic factor (BDNF) is suspected to be one such actor due to its neurotrophic effects. The BDNF precursor, pro-BDNF, has different effects, as it mainly promotes neuronal apoptosis. Both forms also play a role in depression and depressive episodes (DE). The aim of this exploratory study was to compare serum BDNF and pro-BDNF levels in patients with AUDs after withdrawal and according to DE status with those of controls without AUDs or DE. Materials and methodsNinety-nine AUD patients and 40 controls were included. Questionnaires were used to assess both alcohol and psychiatric domains: the severity of hazardous alcohol consumption was assessed using Alcohol Use Disorders Identification Test (AUDIT), craving was assessed using Obsessive and Compulsive Drinking Scale (OCDS), anxiety was assessed with Hamilton Anxiety Rating Scale (HAM-A) and depression with Montgomery-Åsberg Depression Rating Scale (MADRS). Blood samples were collected during two visits: at the time of alcohol withdrawal (M0) and two months later (M2). ELISAs to measure serum BDNF and pro-BDNF levels were performed. AUD patients were categorized according to depression status at M2. Forty-five patients remained abstinent whereas 54 relapsed. BDNF serum levels rose after alcohol withdrawal, but pro-BDNF levels did not vary between M0 and M2. ResultsAUD subjects without DE at M2 had higher BDNF levels at both M0 and M2 than AUD subjects with DE at M2. AUD subjects showed lower MADRS and OCD scores at M2 than at M0. AUD subjects without DE had lower BDNF levels at M0 than controls but not at M2, regardless of abstinence maintenance. ConclusionBDNF serum levels were reduced in AUD patients compared to controls and were further reduced in patients with both AUDs and DE. Alcohol withdrawal treatment was sufficient to induce an increase in serum BDNF levels after 2 months, regardless of whether abstinence was maintained during this time period.

The effectiveness of reduction in alcohol consumption achieved by the provision of non-alcoholic beverages associates with Alcohol Use Disorders Identification Test scores: a secondary analysis of a randomized controlled trial

BackgroundThe Alcohol Use Disorders Identification Test (AUDIT) is commonly used in clinical settings to assess the severity of alcohol-related problems, with the effectiveness of alcohol reduction interventions varying across this spectrum. In a recent study, we demonstrated that a 12-week intervention involving the provision of free non-alcoholic beverages reduced alcohol consumption among heavy drinkers for up to 8 weeks post-intervention. However, it remains unclear whether this effect was consistent across different AUDIT score ranges. Therefore, this secondary analysis aimed to examine whether the severity of alcohol-related problems, as indicated by AUDIT scores, influences the effectiveness of non-alcoholic beverage provision in reducing alcohol consumption.MethodsThis was a single-center, open-label, randomized, parallel-group study. Participants were Japanese individuals who frequently consumed large quantities of alcohol (at least 40 g/day for men and 20 g/day for women) but were not diagnosed with alcohol dependence. Participants were randomly assigned to either an intervention or control group. The intervention group received free non-alcoholic beverages once every 4 weeks over a 12-week period (24 bottles of 350 mL per case, up to three cases per session, for a total of three sessions). Alcohol and non-alcoholic beverage consumption over the previous 4 weeks was tracked using a drinking diary. For this secondary analysis, participants were categorized into four groups based on their AUDIT scores (group 1: ≤ 7 points, group 2: 8–11 points, group 3: 12–14 points, and group 4: ≥ 15 points), and changes in alcohol consumption were compared across these groups in both the intervention and control participants.ResultsThe provision of non-alcoholic beverages significantly increased non-alcoholic beverage consumption in all groups. However, alcohol consumption was significantly reduced in the intervention groups compared to controls only in groups 1–3. The reduction in alcohol consumption was less pronounced in groups 3 and 4 compared to group 1 (both, p < 0.05). Importantly, the provision of non-alcoholic beverages did not lead to an increase in alcohol consumption, even among individuals with higher AUDIT scores.ConclusionsThese findings suggest that individuals with higher AUDIT scores may experience a reduced benefit from a 12-week non-alcoholic beverage intervention in terms of alcohol consumption reduction. Nevertheless, this intervention appears to be a safe and effective strategy for reducing alcohol consumption in heavy drinkers who do not have alcohol dependence.Trial registrationUMIN UMIN000047949. Registered 4 June 2022.

Abnormal developmental of hippocampal subfields and amygdalar subnuclei volumes in young adults with heavy cannabis use: A three-year longitudinal study

BackgroundDifferences in the volumes of the hippocampus and amygdala have consistently been observed between young adults with heavy cannabis use relative to their non-using counterparts. However, it remains unclear whether the subfields of these functionally and structurally heterogenous regions exhibit similar patterns of change in young adults with long-term heavy cannabis use disorder (CUD). ObjectivesThis study aims to investigate the effects of long-term heavy cannabis use in young adults on the subregional structures of the hippocampus and amygdala, as well as their longitudinal alterations. MethodsThe study sample comprised 20 young adults with heavy cannabis use and 22 matched non-cannabis using healthy volunteers. All participants completed the Cannabis Use Disorder Identification Test (CUDIT) and underwent two T1-structural magnetic resonance imaging (MRI) scans, one at baseline and another at follow-up 3 years later. The amygdala, hippocampus, and their subregions were segmented on T1-weighted anatomical MRI scans, using a previously validated procedure. ResultsAt baseline, young adults with heavy CUD exhibited significantly larger volumes in several hippocampal (bilateral presubiculum, subiculum, Cornu Ammonis (CA) regions CA1, CA2-CA3, and right CA4-Dentate Gyrus (DG)) and amygdala (bilateral paralaminar nuclei, right medial nucleus, and right lateral nucleus) subregions compared to healthy controls, but these differences were attenuated at follow-up. Longitudinal analysis revealed an accelerated volumetric decrease in these subregions in young adults with heavy CUD relative to controls. Particularly, compared to healthy controls, significant accelerated volume decreases were observed in the right hippocampal subfields of the parasubiculum, subiculum, and CA4-DG. In the amygdala, similar trends of accelerated volumetric decreases were observed in the left central nucleus, right paralaminar nucleus, right basal nucleus, and right accessory basal nucleus. ConclusionsThe current findings suggest that long-term heavy cannabis use impacts maturational process of the amygdala and hippocampus, especially in subregions with high concentrations of cannabinoid type 1 receptors (CB1Rs) and involvement in adult neurogenesis.

Screening Tools for Alcohol Use Disorder Among Older Adults: A Scoping Review.

As the number of older adults increases, the volume of alcohol-related problems among the older adult population also rises. The purpose of the current scoping review was to summarize and disseminate research findings related to screening for alcohol use disorder (AUD) in older adults (aged ≥60 years) and determine if research gaps exist in the current literature. The concepts of older adults, screening tools, AUD, and instrument evaluation were searched in Medline, APA PsycINFO, and CINAHL. After eligibility criteria were established, screening was completed using Covidence software. Data extracted from each study included the instrument used, method of evaluation, and findings. Seven studies remained after screening. None of the studies took place in the United States. The Alcohol Use Disorders Identification Test and related variations were used most often and were found to be adequate for detecting at-risk drinking among older adults. In addition, some studies suggested lower screening limits for older adults. As the percentage of older adults engaging in risky or hazardous drinking patterns grows, there is an increased need for AUD screening using a reliable tool. Current research is limited; more research is needed regarding which tools perform best in various settings, as well as how to interpret instrument results for older adults. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Digitalisation of gambling harm? Gambling consumption, negative consequences, and clinical characteristics among Swedish help-seekers

Gambling is connected to a range of harms and negative consequences. Gambling is also evolving at a fast pace, particularly in digital environments. Understanding the effects of this on-going change and digitalisation of gambling markets requires systematic measuring of gambling consumption patterns, clinical characteristics, and gambling-related harms.The current study compares two cohorts of help-seekers for gambling in Sweden (2019; 2023), recruited via the Swedish national helpline. The aim is to assess harms and consumption across the two cohorts at a time of increased offer of digital gambling in Sweden. We used eight different screens to measure gambling-related behaviours and consequences, including the Gambling Disorder Identification Test (GDIT). Results were analysed using descriptive statistics, and differences across the two cohorts were tested for statistical significance.The results show that across 2019–2023, gambling consumption has intensified. Online EGMs are by far the most prevalent form of gambling among help-seekers. We also found that the experience of co-morbidities as well as most gambling-related harms were common in both cohorts, with some statistically significant increases in 2023. Harms were more commonly experienced amongst those who engaged in online EGM gambling in comparison to those who did not.The results suggest that the digitalisation of gambling and gambling products appears to be associated with a variety of harmful consequences. The results also show the importance of systematic and comprehensive measurement to capture different severity levels of harms and their wide range amongst those who gamble.

Associations between changes in deprivation and alcohol use disorder: a nationwide longitudinal study.

Despite conflicting findings on the association between socioeconomic status and drinking, little is known about the impact of deprivation as a measure of inequality on alcohol use disorders (AUDs). We used the Korea Welfare Panel Study, a longitudinal survey conducted from 2012 to 2022, and included 1569 Korean adult participants. Deprivation (at least one including food, housing, medical, educational, and credit deprivation) was measured by self-report and divided into four categories according to the change in deprivation experience from the previous year to the following year. AUD was measured using the Korean version of the Alcohol Use Disorders Identification Test scale. Multivariable logistic regression was used to estimate odds ratios and 95% confidence intervals and adjusted for confounders. Among 1569 participants, worsened deprivation and consistent deprivation were positively associated with AUD compared to non-deprivation. In particular, worsened deprivation was more likely to be associated with AUD in participants with low household income, high school education level, and economic activity. We found that worsened deprivation and consistent deprivation were associated with AUD. Deprivation should be considered as a health policy intervention to improve drinking problems.