Alcohol Problem Drinking Research Articles

The mediated model of PTSD between ADHD symptoms and alcohol abuse in a population of college students in Taiwan

PurposeImpulsivity, inattention, childhood trauma, PTSD, and depressive symptoms were the high-risk factors of alcohol abuse in ADHD symptoms. There is a lack of a comprehensive framework of trauma and PTSD in ADHD symptoms with alcohol abuse to explain why ADHD college students become problematic alcohol drinking. Method521 college students were recruited from online platforms (e.g., Facebook, LINE, or Google) after informed consent (females, 67.9%, n = 354; averaged age = 20.34, S.D. = 1.98). All of them completed the questionnaires, which included symptoms of ADHD, inattention and impulsivity, depressive symptoms, childhood trauma, PTSD symptoms, and problematic alcohol drinking. One-way ANOVA and path analysis were applied to examine the significance of eight paths. ResultsOur results supported the mediating effects of childhood trauma and PTSD symptoms in ADHD symptoms with problematic alcohol drinking. DiscussionThe effect of complex PTSD between impulsivity and problematic alcohol drinking is still unclear. In addition to impulsivity and inattention to ADHD symptoms with problematic alcohol drinking, the impact of hyperactivity also needs to be considered. ConclusionsEffective treatment for ADHD symptoms with alcohol abuse could focus on self-control training and emotional regulation in the future.

Limited bedding and nesting increases ethanol drinking in female rats

Prenatal opioid exposure (POE) and postnatal adverse experiences are early life adversities (ELA) that often co-occur and increase problematic alcohol (EtOH) drinking during adolescence. We investigated the relationship between POE, postnatal adversity, and adolescent EtOH drinking in rats. We also sought to determine whether ELAs affect alpha-adrenoceptor density in the brain because the noradrenergic system is involved in problematic alcohol drinking and its treatment. We hypothesized that the combination of POE and postnatal adversity will increase alcohol drinking in rats compared to rats with exposure to either adversity alone or to control. We also predicted that POE and postnatal adversity would increase α1-adrenoceptor density and decrease α2-adrenoceptor density in brain to confer a stress-responsive phenotype. Pregnant rats received morphine (15 mg/kg/day) or saline via subcutaneous minipumps from gestational day 9 until birth. Limited bedding and nesting (LBN) procedures were introduced from postnatal day (PD) 3-11 to mimic early life adversity-scarcity. Offspring rats (PD 31-33) were given opportunities to drink EtOH (20 %, v/v) using intermittent-access, two-bottle choice (with water) procedures. Rats given access to EtOH were assigned into sub-groups that were injected with either yohimbine (1 mg/kg, ip) or vehicle (2 % DMSO, ip) 30 min prior to each EtOH access session to determine the effects of α2-adrenoceptor inhibition on alcohol drinking. We harvested cortices, brainstems, and hypothalami from EtOH-naïve littermates on either PD 30 or PD 70 and conducted radioligand receptor binding assays to quantify α1- and α2-adrenoceptor densities. Contrary to our hypothesis, only LBN alone increased EtOH intake in female adolescent rats compared to female rats with POE. Neither POE nor LBN affected α1- or α2-adrenoceptor densities in the cortex, brainstem, or hypothalamus of early- or late-aged adolescent rats. These results suggest a complex interaction between ELA type and sex on alcohol drinking.

The mediating role of Dark Triad of personality in the relationship between biological sex and problematic alcohol drinking in university students

The mediating role of Dark Triad of personality in the relationship between biological sex and problematic alcohol drinking in university students

Alcohol, HMGB1, and Innate Immune Signaling in the Brain.

Binge drinking (i.e., consuming enough alcohol to achieve a blood ethanol concentration of 80 mg/dL, approximately 4-5 drinks within 2 hours), particularly in early adolescence, can promote progressive increases in alcohol drinking and alcohol-related problems that develop into compulsive use in the chronic relapsing disease, alcohol use disorder (AUD). Over the past decade, neuroimmune signaling has been discovered to contribute to alcohol-induced changes in drinking, mood, and neurodegeneration. This review presents a mechanistic hypothesis supporting high mobility group box protein 1 (HMGB1) and Toll-like receptor (TLR) signaling as key elements of alcohol-induced neuroimmune signaling across glia and neurons, which shifts gene transcription and synapses, altering neuronal networks that contribute to the development of AUD. This hypothesis may help guide further research on prevention and treatment. The authors used the search terms "HMGB1 protein," "alcohol," and "brain" across PubMed, Scopus, and Embase to find articles published between 1991 and 2023. The database search found 54 references in PubMed, 47 in Scopus, and 105 in Embase. A total of about 100 articles were included. In the brain, immune signaling molecules play a role in normal development that differs from their functions in inflammation and the immune response, although cellular receptors and signaling are shared. In adults, pro-inflammatory signals have emerged as contributing to brain adaptation in stress, depression, AUD, and neurodegenerative diseases. HMGB1, a cytokine-like signaling protein released from activated cells, including neurons, is hypothesized to activate pro-inflammatory signals through TLRs that contribute to adaptations to binge and chronic heavy drinking. HMGB1 alone and in heteromers with other molecules activates TLRs and other immune receptors that spread signaling across neurons and glia. Both blood and brain levels of HMGB1 increase with ethanol exposure. In rats, an adolescent intermittent ethanol (AIE) binge drinking model persistently increases brain HMGB1 and its receptors; alters microglia, forebrain cholinergic neurons, and neuronal networks; and increases alcohol drinking and anxiety while disrupting cognition. Studies of human postmortem AUD brain have found elevated levels of HMGB1 and TLRs. These signals reduce cholinergic neurons, whereas microglia, the brain's immune cells, are activated by binge drinking. Microglia regulate synapses through complement proteins that can change networks affected by AIE that increase drinking, contributing to risks for AUD. Anti-inflammatory drugs, exercise, cholinesterase inhibitors, and histone deacetylase epigenetic inhibitors prevent and reverse the AIE-induced pathology. Further, HMGB1 antagonists and other anti-inflammatory treatments may provide new therapies for alcohol misuse and AUD. Collectively, these findings suggest that restoring the innate immune signaling balance is central to recovering from alcohol-related pathology.

Psychologic Welfare and Burnout of Medical Students after COVID-19 Pandemic Lockdown in Poland

Abstract Objectives: In this study, we intended to examine the psychological welfare, burnout, and stress-related coping mechanisms of medical students at the Medical University of Gdańsk, Gdańsk, Poland. Under the hypothesis that depressive symptoms and screening for problem alcohol drinking would predict the risk of burnout, we intended to study the relationship between selected variables (e.g., demographic and socioeconomic) and burnout risk and the effects of abandonment of social isolation restrictions related to the COVID-19 pandemic lockdown. Methods: Medical students completed an online survey assessing general mental health and stress coping mechanisms. We used copies of the Patient Health Questionnaire 9-item (PHQ-9); Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire; and the Oldenburg Burnout Inventory (OLBI), to quantify depressive symptoms, screen for problematic alcohol drinking, and assess the risk of burnout. Results: The mean total OLBI score ± standard deviation was 44.6 ± 7.3 (N = 700), with 91.1% of participants scoring ≥ 35 points. Female students had significantly higher total and exhaustion domain OLBI scores than their male counterparts (p < 0.05). About 76% of all respondents reported high levels of studies-related stress and 44% of survey participants agreed/strongly agreed that they considered dropping out of university courses due to the stress. The suicidal/self-harm ideations were found in 33.6% of students. Most students (64.4%) were screened positively for moderate-to-severe depressive symptoms, and 19% of them for risky alcohol use. Students with OLBI scores ≥ 35 achieved notably higher PHQ-9 and CAGE results. The results of multivariate regression analysis showed that PHQ-9 (p < 0.05) and CAGE (p < 0.05) questionnaire significantly predicted the OLBI score. Conclusion: Medical students are a vulnerable group at risk of developing mental health problems. A great number of survey participants screened positively for the presence of depressive symptoms, risky alcohol use, and burnout. The PHQ-9, and CAGE results, was significant predictor of OLBI outcomes. The improvement of COVID-19 pandemic-related social isolation restrictions did not produce a marked improvement in somatic/mental health-related quantifiers as compared to the time of strict social restrictions.

Relationship between Household Type and Problematic Alcohol Drinking in University Students

Relationship between Household Type and Problematic Alcohol Drinking in University Students

Treatment outcomes of alcohol use disorder by traditional medicine practitioners using plant derivatives in southwestern Uganda: findings from in-depth interviews.

Globally, 5.1% of the global burden of disease and injury is attributable to alcohol in addition to its significant negative socio-economic impact. Uganda is ranked among the highest alcohol consuming countries in Africa with a reported alcohol per capita consumption of 9.5 liters, much higher than the 6.3 for the African region. Additionally, almost 10% of Ugandans aged 18 and older have an alcohol use disorder. African traditional medicine plays an important role towards universal health coverage in sub-Saharan Africa especially in rural areas. Anecdotal evidence shows that herbal medicines are used by traditional medicine practitioners (TMPs) to treat alcohol drinking problems in Uganda. Data on the outcomes of alcohol treatment by TMPs is scarce. We aimed at documenting the treatment outcomes and secondary benefits of people treated by TMPs using plant derivatives in southwestern Uganda. This was a cross-sectional semi-structured qualitative study that investigated alcohol drinking history and treatment outcomes of adults living in Bushenyi district, southwestern Uganda. We used a semi-structured questionnaire to conduct face-to-face in-depths interviews with individuals who had been treated for alcohol drinking problems by TMPs using plant derivatives. Three trained research assistants collected the data using audio recordings backed by field notes. The audio recordings were transcribed verbatim and two independent researchers coded the transcripts guided by a priori themes developed by the research team. We conducted 44 in-depths interviews, majority of the participants (70.5%, 31/44) were male with a mean age of 47 years. Most participants (86.2%, 38/44) consumed spirits in addition to other types of alcohol and the mean duration of alcohol drinking before seeking treatment was 14 years. Most participants (93.3%, 41/44) abstained from drinking after treatment by the TMPs with only 6.7% (3/44) continuing to drink but less amounts. All participants described additional benefits after treatment including improvement in health, family relations and image in society. People who were treatment for alcohol drinking problems by traditional healers using plant derivatives in this study described personal and social benefits after stopping drinking. This calls for further research to the plants used.

Association of lifetime major depressive disorder with enhanced attentional sensitivity measured with P3 response in young adult twins

Major depression is associated with alterations in the auditory P3 event-related potential (ERP). However, the persistence of these abnormalities after recovery from depressive episodes, especially in young adults, is not well known. Furthermore, the potential influence of substance use on this association is poorly understood. Young adult twin pairs (N = 177) from the longitudinal FinnTwin16 study were studied with a psychiatric interview, and P3a and P3b ERPs elicited by task-irrelevant novel sounds and targets, respectively. Dyadic linear mixed-effect models were used to distinguish the effects of lifetime major depressive disorder from familial factors and effects of alcohol problem drinking and tobacco smoking. P3a amplitude was significantly increased and P3b latency decreased, in individuals with a history of lifetime major depression, when controlling the fixed effects of alcohol abuse, tobacco, gender, twins’ birth order, and zygosity. These results suggest that past lifetime major depressive disorder may be associated with enhanced attentional sensitivity.

Perceived Social Discrimination, Socioeconomic Status, and Alcohol Consumption among Chinese Adults: A Nationally Representative Study.

Perceived social discrimination in China has significant effects on drinking behavior. This finding was reached through multivariate logistic regression analysis of a sample of 22,566 adults in the 2016 China Family Panel Studies (CFPS). This was a cross-sectional study conducted with computer-assisted face-to-face interviews to assess alcohol drinking problems and associated factors among Chinese adults. The proportion of adults prone to alcoholism tends to be higher in eastern than central China, and higher in central than western China. Furthermore, gender discrimination and delays in government interactions as a result of unfair treatment have a positive and significant effect on individuals’ drinking. The alcohol consumption rate among Chinese men is about 13 times that of Chinese women. Additionally, older people have a stronger tendency to drink alcohol. In terms of education, those with lower education levels are more prone to alcoholism than those with higher education levels. Regarding marital status, those who are married are more prone to alcoholism than those who are not. Further, those who have been diagnosed with a chronic disease within the past six months are less prone to alcoholism than those without such diagnosis. People with an annual income between 50,000 and 150,000 yuan are more prone to alcoholism than those with an income under 50,000 yuan. Groups that have experienced unequal treatment in public services are also more prone to alcoholism than those who do not suffer such unequal treatment.

Updated Positions of Consultancy of the Patient with Drinking Alcohol Problems in the Family Doctor’s Practice (Based on European Experience)

Alcohol use causes many health disorders and other problems. The family physician and his/her staff play an indispensable role in the early detection of dangerous and harmful alcohol in their patients. The purpose is to analyze the current provisions of counseling the patient on the problem of alcohol use in clinical practice by a family doctor, as well as to formulate this skill in the process of teaching based on a European (Croatian) protocol for managing this problem in primary medical practice. The risks and consequences of drinking are an extremely big health problem because of its prevalence and severity. Managing such issues requires a holistic approach from patients, families and the entire community to its institutions and organizations. All physicians, especially family physicians with their staff, who play an essential role in the prevention and, in particular, the early detection of dangerous and harmful alcohol consumption, play a very important role in this. Every doctor, regardless of their specialty, must adopt a basic approach to dealing with alcohol problems. The main tasks of physicians in this situation are the following: ask, evaluate, provide advice, obtain consent and compliance with the patient, provide protocol assistance, and follow-up.

Assessing the Associations between Religiosity and Alcohol Use Stages in a Representative U.S. Sample

Background: Problematic alcohol drinking has been a public health concern in the United States. Studies showed that religiosity serves as a protective factor, delaying the onset of alcohol use, and reducing the frequency of drinking. Few studies, however, have examined these associations with large, nationally representative samples, and even fewer have assessed the impact of religiosity on drinking behavior transitions/changes. Objectives: This study examined a national adult sample to investigate the associations between religiosity and alcohol use stages including initiation, reinitiation, and persistence of alcohol use. Methods: Data from the National Epidemiologic Survey of Alcohol and Related Conditions Waves 1–2 were used. Wave 1 sample included 6113 nondrinkers, 6189 prior drinkers, and 21,950 current drinkers who were at risk for initiation, reinitiation, and persistent use of alcohol, respectively. Religiosity constructs included importance of religious and frequency of practice. Three logistic regressions examined the aforementioned associations. Results: Compared to those not attending religious services, the most frequent attenders exhibited lower odds of initiating alcohol use, reinitiation after prior use, and persistent drinking (ORs = 0.23, 0.51, 0.55, respectively; ps < .01). Those identifying religious beliefs as very important exhibited lower odds of initiation and reinitiation of alcohol use (both ORs = 0.63, ps < .05). Conclusions: Religiosity plays an important role in preventing/delaying alcohol use initiation, reinitiation, and persistence. Incorporating religiosity aspects (e.g. meditation) into alcohol prevention and control programs may serve to increase protective effects. Future studies should seek to delineate what religiosity factors can be leveraged and embedded into secular prevention programs delivered to youth and adolescents.

Effect of Alcohol on Hippocampal-Dependent Plasticity and Behavior: Role of Glutamatergic Synaptic Transmission.

Problematic alcohol drinking and alcohol dependence are an increasing health problem worldwide. Alcohol abuse is responsible for approximately 5% of the total deaths in the world, but addictive consumption of it has a substantial impact on neurological and memory disabilities throughout the population. One of the better-studied brain areas involved in cognitive functions is the hippocampus, which is also an essential brain region targeted by ethanol. Accumulated evidence in several rodent models has shown that ethanol treatment produces cognitive impairment in hippocampal-dependent tasks. These adverse effects may be related to the fact that ethanol impairs the cellular and synaptic plasticity mechanisms, including adverse changes in neuronal morphology, spine architecture, neuronal communication, and finally an increase in neuronal death. There is evidence that the damage that occurs in the different brain structures is varied according to the stage of development during which the subjects are exposed to ethanol, and even much earlier exposure to it would cause damage in the adult stage. Studies on the cellular and cognitive deficiencies produced by alcohol in the brain are needed in order to search for new strategies to reduce alcohol neuronal toxicity and to understand its consequences on memory and cognitive performance with emphasis on the crucial stages of development, including prenatal events to adulthood.

Some aspects of tobacco smoking in the context of alcohol drinking, hangover and mental health problems

The public health relevance of hangover is in its potential effects on occupational safety and performance. Apart from pharmacological effects of ethanol and congeners, psychosocial factors also contribute to morning-after feelings, particularly the emotions of shame and guilt. Tobacco smoking increases the hangover’s incidence and severity, explained by pharmacological effects of nicotine and other smoke constituents. During a drinking binge, many people would smoke more than usual; some intermittent smokers or those who gave up would restart. The hangover “curing” with beer or vodka the next morning (hair of the dog) may contribute to negative affectivity in the long run, as it implies a cycle of alcohol consumption and shame. Some individuals experience a temporary symptomatic relief after a hair of the dog drink. According to our observations, if the “curing” is accompanied by smoking, the elevated mood in some people would more easily shift to dysphoria, irritation or depression. Psychological mechanisms thereof are discussed here. Besides, the problem of smoking in psychiatric hospitals is briefly discussed. In conclusion, smoking can exacerbate hangover symptoms through both toxicological and psychosocial mechanisms. The problem of smoking in the settings of alcoholism and mental health problems should be further investigated.

PROBLEMATIC ALCOHOL USE IN TEAM AND INDIVIDUAL EXERCISE SETTINGS

Background. The scholastic literature suggests that alcohol use may be a problem in team sports, but data on the general or average exercisers are lacking. This inquiry examined the prevalence of use and the level of problematic use of alcohol in a highly heterogeneous group of team and individual exercisers. Methods. Two-hundred exercising male (n = 79) and female (n = 121) participants (M age = 26.79 ± SD = 7.88 years) answered demographic questions and completed the Alcohol Use Disorder Identification Test (AUDIT). Results. The rate of alcohol drinkers did not differ between the groups, but males exercising in team settings reported higher levels of alcohol drinking problems than individual exercisers in general. The findings were similar for older (aged 25 years and over) adults too, as shown by a separate analysis of the latter group. The frequency and volume of exercise were unrelated to problematic alcohol use. Cases of high level of alcohol use problems were twice as many in team than in individual exercisers. Conclusions. The prevalence of alcohol use in team and individual exercisers is similar, but problematic alcohol use is greater in the former group. Increased alcohol use problems in team exercisers seem to be limited to men and it occurs in older adults too. Men drink more than women, but the behaviour may have a general social, rather than a sport-specific, context.

Perceptions of problem-drinker patients’ family members about their own hazardous-drinking behaviours in Chinese general hospitals

BackgroundExcessive alcohol use has been associated with health, social and legal problems. Studies of alcohol-drinking problems have mainly focused on patients with alcohol-drinking problems and few studies have focused on their family members. The purpose of this study was to explore the perceptions of family members of problem-drinker patients about their own hazardous or harmful alcohol-drinking behaviours.MethodsIn this qualitative descriptive study, participants were recruited from three hospitals randomly selected from northern and central Taiwan (2:1). Hazardous-drinker patients and their family members were screened using the Chinese version AUDIT. AUDIT scores &gt; 8 indicated harmful or hazardous drinkers. Data were collected in individual, audiotaped, in-depth interviews using an interview guide. Verbatim interview transcripts were analysed using ATLAS.ti, version WIN 7.0.ResultsThe sample of 35 family members with hazardous or harmful drinking behaviours perceived that their own alcohol-drinking behaviours were related to six major patterns: family habits, leisure activities with friends, work pressures, personal taste, a way to forget one's problems and to express happiness.ConclusionsWe recommend that programs to prevent harmful or hazardous drinking should emphasize understanding standard amounts of alcohol in alcoholic beverages, recommended amounts of alcohol consumption for males and females, knowledge about the long-term effects of excessive alcohol consumption; offer strategies to resist social pressure to drink; and build positive strategies for coping with stress.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Alcohol Use Disorders in Argentinian Girls and Women 12 Months Before Delivery: Comparison of DSM-IV, DSM-5, and ICD-10 Diagnostic Criteria

The evidence of important problems related to prenatal alcohol exposure has faced researchers with the problem of understanding and screening alcohol use in this population. Although any alcohol use should be considered risky during pregnancy, identifying alcohol-drinking problems (ADPs) could be especially important because women with ADPs could not benefit from a simple advice of abstinence and because their offsprings are subjected to a higher risk of problems related with prenatal alcohol exposure. In this context, we aim to study the prevalence and characteristics of ADPs in pregnant women, evaluating the performance of different diagnostic systems in this population. The aims of the study were to describe the prevalence of ADPs obtained with the criteria of the Diagnostic and Statistical Manual of Mental Disorders in its fourth (DSM-IV) and fifth edition (DSM-5), and the International Classification of Diseases (ICD)-10, in Argentinean females aged 13 to 44 years, 12 months before delivery; to evaluate the level of agreement between these classification systems; and to analyze the performance of each diagnosis criterion in this population. Data were collected through personal interviews of a probability sample of puerperal women (N = 641) in the city of Santa Fe (Argentina), between October 2010 and February 2011. Diagnoses compatible with DSM-IV, DSM-5, and ICD-10 were obtained through the Composite International Diagnostic Interview. Agreement among diagnostic systems was measured through Cohen kappa. Diagnosis criteria performance were analyzed considering their prevalence and discriminating ability (D value). Total ADP prevalence was 6.4% for DSM-IV (4.2% abuse and 2.2% dependence), 8.1% for DSM-5 (6.4% mild, 0.8% moderate, and 0.9% severe alcohol use disorder), and 14.1% for the ICD-10 (11.9% harmful use and 2.2% dependence). DSM-5 modifications improved agreement between DSM and ICD. The least prevalent and worst discriminating ability diagnostic criterion was "legal problems." The most prevalent and 1 of the best discriminating ability diagnostic criterion was '"health issues." DSM-IV and ICD-10 dependence prevalence was similar to that of previous studies in pregnant women, whereas abuse prevalence was surprisingly higher. Our results indicate a better performance of the DSM-5 alcohol use disorder category relative to the DSM-IV dual categorization. Nevertheless, the poor diagnostic performance of some DSM-5 criteria in this population could evidence their intercultural variability.

Alcohol use and alcohol-related problems among adolescents in China: A large-scale cross-sectional study.

Alcohol misuse among adolescents is a common issue worldwide and is an emerging problem in China. This study aimed to investigate the prevalence of alcohol drinking and alcohol-related problems among Chinese adolescents and to explore their risk factors and connections.A cross-sectional study using an anonymous questionnaire was conducted among junior and senior high school students between 2010 and 2012. Data on self-reported alcohol use, alcohol-related problems, school factors, family factors, and psychosocial factors were collected. Descriptive analyses were made of the proportions of sociodemographics, family, school, and psychosocial factors. Multilevel logistic regression models were conducted to analyze the risk factors for alcohol drinking and alcohol-related problems.Of the 105,752 students who ranged in age from 9 to 21 years, the prevalence of current drinking among students was 7.3%, and 13.2% students reported having alcohol-related problems. Male students were 1.78 (95% confidence interval [CI] = 1.69–1.87) times more likely to be involved in current drinking and 1.86 (95% CI = 1.79–1.93) times more likely to have alcohol-related problems. Higher grade level students were at a higher risk of current drinking (adjusted odds ratio [AOR] = 1.09, 95% CI = 1.05–1.13) and having alcohol-related problems (AOR = 1.43, 95% CI = 1.42–1.58). Older students were more likely to report current drinking (AOR = 1.06, 95% CI = 1.04–1.17) and having alcohol-related problems (AOR = 1.83, 95% CI = 1.82–1.85). Having poor classmate relations (AOR = 1.28, 95% CI = 1.03–1.37), having poor relationships with teachers (AOR = 1.08, 95% CI = 1.00–1.16), and below average academic achievement (AOR = 1.50, 95% CI = 1.41–1.59) were positively associated with current drinking. Moreover, students with suicidal ideation were at a higher risk of current drinking (AOR = 1.70, 95% CI = 1.61–1.81) and having alcohol-related problems (AOR = 2.08, 95% CI = 1.98–2.16). Having higher Center for Epidemiology Scale for Depression scores was positively associated with current drinking (AOR = 1.09, 95% CI = 1.05–1.11) and having alcohol-related problems (AOR = 1.08, 95% CI = 1.06–1.18).Alcohol drinking and alcohol-related problems among Chinese adolescents are major public health problems, and effective preventive programs will require full consideration of the individual, social, and environmental factors that facilitate and prevent alcohol use.

Reported alcohol drinking and mental health problems in Hong Kong Chinese adolescents

ObjectiveTo investigate the association between reported alcohol drinking and mental health problems in Hong Kong adolescents. MethodsIn a school-based questionnaire survey in 2012-13 on 4620 Secondary one (US Grade seven) to six students (mean age 14.5, SD 1.6 years; 53.4% boys), alcohol drinking was classified as never drinking (reference), experimental, former, less-than-weekly and weekly drinking. Binge drinking was defined as drinking at least five drinks on one occasion. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) with five subscales (emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial activity) and the total difficulties score (sum of the first four subscales). Multilevel regression was used to analyse the associations of mental health problems with drinking frequency and binge drinking, adjusting for potential confounders. ResultsCompared with never drinking, higher total difficulties scores were associated with less-than-weekly drinking (adjusted odds ratio AOR 1.39, 95% CI 1.01–1.91), weekly drinking (AOR 3.21, 95% CI 2.18–4.70), and binge drinking (AOR 2.18, 95% CI 1.42–3.32). Weekly drinking was most strongly associated with hyperactivity (AOR 6.27, 95% CI 1.42–3.32) among all subscales. Girls were more likely than boys to report emotional problems (AOR 3.36 vs 1.47) and hyperactivity (AOR 19.2 vs 2.31) related to weekly alcohol drinking (both P for interaction <0.05). ConclusionsIn Hong Kong adolescents, less-than-weekly, weekly, and binge drinking are associated with higher risks of mental health problems based on self-reported data. Prospective studies are warranted to explore the causality between alcohol drinking and mental health problems.

Evaluating the (cost-)effectiveness of guided and unguided Internet-based self-help for problematic alcohol use in employees--a three arm randomized controlled trial.

BackgroundProblematic alcohol consumption is associated with a high disease burden for affected individuals and has a detrimental impact on companies and society due to direct and indirect health costs. This protocol describes a study design to evaluate the (cost)-effectiveness of a guided and unguided Internet-based self-help intervention for employees called “GET.ON Clever weniger trinken” (be smart – drink less) compared to a waiting list control group.MethodsIn a three-arm randomized controlled trial, 528 German adults who are currently members of the workforce will be recruited by occupational health departments of major health insurance companies. Employees aged 18 and older displaying problematic drinking patterns (>21/14 drinks per week and an AUDIT score > 8/6 for men/women) will be randomly assigned to one of three following study conditions: 1. unguided web-based self-help for problematic drinking, 2. adherence-focused guided self-help, and 3. waiting list control. Self-report data will be collected at baseline (T1), 6 weeks (T2), and 6 months (T3) after randomization. The primary outcome will be the reduction of alcohol standard units during the 7 days prior to T2, using the Timeline Followback method. Cost-effectiveness analyses to determine direct and indirect costs will be conducted from the perspectives of employers and the society. Data will be analyzed on an intention-to-treat basis and per protocol.DiscussionThere is a need to identify effective low-threshold solutions to improve ill-health and reduce the negative economic consequences due to problematic alcohol drinking in workforces. If the proposed web-based intervention proves both to be efficacious and cost-effective, it may be a useful tool to increase utilization rates of interventions for problematic drinking in occupational settings.Trial RegistrationGerman Register of Clinical Studies (DRKS): DRKS00006105, date of registration: 2014-07-07.

Different effect of alcohol consumption on hypertension according to metabolic health status.

We aimed to investigate whether the effect of problematic alcohol drinking on hypertension differed according to metabolic health statuses. Male participants from the fifth Korea National Health and Nutrition Examination Survey were recruited. Problematic alcohol drinkers were designated as subjects with heavy drinking (⩾30 g per day), binge drinking (⩾7 glasses per day) or a high alcohol use disorders identification test score (⩾20). Metabolically obese status was defined as having ⩾1 or ⩾2 components of the diagnostic criteria for metabolic syndrome, excluding the blood pressure component. Because the prevalence of problematic alcohol drinking and the prevalence of hypertension largely differed by age groups, separate analyses were performed for the two age groups (<50 and ⩾50 years). Among a total of 6329 subjects, 37.04% had hypertension. In the younger age group, subjects with problematic alcohol drinking demonstrated a higher prevalence of hypertension in both nonobese and obese individuals compared with subjects who were nonobese and who were not problematic alcohol drinkers. Of note, problematic alcohol drinking increased the risk of having hypertension ∼3 times in young nonobese individuals who demonstrated a metabolically obese phenotype compared with those who were metabolically healthy. However, metabolic health status did not have a significant impact on the risk for having hypertension in obese participants, regardless of their age groups. For the prevention of hypertension, avoidance of problematic alcohol drinking should be emphasized, especially in young subjects who show poor metabolic health status despite being nonobese.