Lifetime Prevalence Of Alcohol Abuse Research Articles

Alcoholism and critical illness: A review.

Alcohol is the most commonly used and abused drug in the world, and alcohol use disorders pose a tremendous burden to healthcare systems around the world. The lifetime prevalence of alcohol abuse in the United States is estimated to be around 18%, and the economic consequences of these disorders are staggering. Studies on hospitalized patients demonstrate that about one in four patients admitted to critical care units will have alcohol-related issues, and unhealthy alcohol consumption is responsible for numerous clinical problems encountered in intensive care unit (ICU) settings. Patients with alcohol use disorders are not only predisposed to developing withdrawal syndromes and other conditions that often require intensive care, they also experience a considerably higher rate of complications, longer ICU and hospital length of stay, greater resource utilization, and significantly increased mortality compared to similar critically ill patients who do not abuse alcohol. Specific disorders seen in the critical care setting that are impacted by alcohol abuse include delirium, pneumonia, acute respiratory distress syndrome, sepsis, gastrointestinal hemorrhage, trauma, and burn injuries. Despite the substantial burden of alcohol-induced disease in these settings, critical care providers often fail to identify individuals with alcohol use disorders, which can have significant implications for this vulnerable population and delay important clinical interventions.

Psychiatric Comorbidity, Suicidality, and In-Home Firearm Access among a Nationally Representative Sample of Adolescents: Simonetti JA, Mackelprang JL, Rowhani-Rahbar A, et al. JAMA Psychiatry 2015;72:152–9.

The objectives of this study were to estimate the prevalence of self-reported in-home firearm access among adolescents, quantify the lifetime prevalence of mental illness and suicidality among those adolescents with firearm access in-home, and to compare the prevalence of in-home firearm access between adolescents with and without specific mental health risk factors for suicide. The study was a cross-sectional analysis of data from the National Comorbidity Survey – Adolescent Supplement, a nationally representative survey of 10,123 US adolescents (ages 13–18 years) who were interviewed between February 2001 and January 2004. The primary outcome for the study was self-reported access to a firearm in the home. About 1 in 3 (30.7%) of the adolescent survey respondents reported living in a home with one or more firearms. Of the respondents, 1089 (11.4% of total responders and 40.9% of those with firearm in-home) adolescents reported easy access and the ability to shoot that firearm. Among adolescents with a firearm in-home, those with access were significantly more likely to be male (70.1% vs. 50.9%), of non-Hispanic white race/ethnicity (86.6% vs. 78.3%), living in high-income households (40.0% vs. 31.8%), and in rural areas (28.1% vs. 22.6%) (P < .05 for all). Adolescents with firearm access also had higher lifetime prevalence of alcohol abuse (10.1% vs. 3.8%, P < .001), recent history of alcohol abuse (8.2% vs. 2.9%), and drug abuse (11.4% vs. 6.9%) (P < .01 for all). In multivariable analysis, adolescents with a history of mental illness without history of suicidality (prevalence ratio [PR] 1.13; 95% confidence interval [CI] 0.98–1.29) and adolescents with a history of suicidality with or without a history of mental illness (PR 1.20; 95% CI 0.96–1.51) were as likely to report in-home firearm access as those without such histories. The authors concluded that adolescents with risk factors for suicide were equally as likely to have in-home firearm access as those adolescents without such risk factors.

Psychiatric comorbidity, suicidality, and in-home firearm access among a nationally representative sample of adolescents.

Suicide is the second leading cause of death among US adolescents, and in-home firearm access is an independent risk factor for suicide. Given recommendations to limit firearm access by those with mental health risk factors for suicide, we hypothesized that adolescents with such risk factors would be less likely to report in-home firearm access. To estimate the prevalence of self-reported in-home firearm access among US adolescents, to quantify the lifetime prevalence of mental illness and suicidality (ie, suicidal ideation, planning, or attempt) among adolescents living with a firearm in the home, and to compare the prevalence of in-home firearm access between adolescents with and without specific mental health risk factors for suicide. Cross-sectional analysis of data from the National Comorbidity Survey-Adolescent Supplement, a nationally representative survey of 10,123 US adolescents (age range, 13-18 years) who were interviewed between February 2001 and January 2004 (response rate 82.9%). Risk factors for suicide, including a history of any mental health disorder, suicidality, or any combination of the 2. Self-reported access to a firearm in the home. One in three respondents (2778 [29.1%]) of the weighted survey sample reported living in a home with a firearm and responded to a question about firearm access; 1089 (40.9%) of those adolescents reported easy access to and the ability to shoot that firearm. Among adolescents with a firearm in home, those with access were significantly more likely to be older (15.6 vs 15.1 years), male (70.1% vs 50.9%), of non-Hispanic white race/ethnicity (86.6% vs 78.3%), and living in high-income households (40.0% vs 31.8%), and in rural areas (28.1% vs 22.6%) (P < .05 for all). Adolescents with firearm access also had a higher lifetime prevalence of alcohol abuse (10.1% vs 3.8%, P < .001) and drug abuse (11.4% vs 6.9%, P < .01) compared with those without firearm access. In multivariable analyses, adolescents with a history of mental illness without a history of suicidality (prevalence ratio [PR], 1.13; 95% CI, 0.98-1.29) and adolescents with a history of suicidality with or without a history of mental illness (PR, 1.20; 95% CI, 0.96-1.51) were as likely to report in-home firearm access as those without such histories. Adolescents with risk factors for suicide were just as likely to report in-home firearm access as those without such risk factors. Given that firearms are the second most common means of suicide among adolescents, further attention to developing and implementing evidence-based strategies to decrease firearm access in this age group is warranted.

SY03-2-2 * NIDA-ISAM FELLOWSHIP LIFETIME PREVALENCE OF ALCOHOL USE DISORDERS IN PERU: FINDINGS FROM THE WORLD MENTAL HEALTH STUDY

Objective. Alcohol use disorders are exceedingly common and result in major public and individual health consequences. However, very little is known about the burden of these conditions in low- and middle-income countries. Our objective is to estimate lifetime prevalence of alcohol use disorders in Peru, we analyzed World Mental Health Survey data. Methods. These data are based on face-to-face interviews in the community using the WHO Composite International Diagnostic Interview (WHO-CIDI). Using a probabilistic multistage sampling design, a total of 3930 adults (age 18–65) were surveyed in five Peruvian cities (Arequipa, Chiclayo, Huancayo, Iquitos and Lima). Results. Overall, the lifetime prevalence of alcohol abuse and dependence were 5.6% and 1.3%, respectively. The lifetime prevalence of alcohol abuse and dependence by gender was 10.7% and 2.6% in males, compared to 0.83% and 0.1% in females. Additionally, the prevalence of lifetime alcohol abuse and dependence varied by city: 2.2% and 1.2% in Arequipa, 3.1% and 1.8% in Chiclayo, 8.2% and 0.48% in Huancayo, 7.0% and 1.4% in Iquitos, and 5.9% and 1.6% in Lima. Conclusion. Understanding the distribution of alcohol disorders will guide public health research and interventions designed to reduce alcohol-related morbidity and mortality.

Prevalence and correlates of alcohol use disorders in the Singapore Mental Health Survey

To establish the prevalence, correlates, comorbidity and treatment gap of alcohol use disorders in the Singapore resident population. The Singapore Mental Health Study is a cross-sectional epidemiological survey. A nationally representative survey of the resident (citizens and permanent residents) population in Singapore. A total of 6616 Singaporean adults aged 18 years and older. The diagnoses were established using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) diagnostic modules for life-time and 12-month prevalence of selected mental illnesses including alcohol use disorders. The life-time prevalence of alcohol abuse and alcohol dependence was 3.1% and 0.5%, while the 12-month prevalence of alcohol abuse and alcohol dependence was 0.5% and 0.3%, respectively. The life-time and 12-month prevalence of alcohol use disorders was 3.6% and 0.8%, respectively. Those with alcohol use disorder had significantly higher odds of having major depressive disorder [odds ratio (OR) 3.1] and nicotine dependence (OR 4.5). Compared to the rest of the population, those with an alcohol use disorder had significantly higher odds of having gastric ulcers (OR 3.0), respiratory conditions (OR 2.1) and chronic pain (OR 2.1). Only one in five of those with alcohol use disorder had ever sought treatment. The prevalence of alcohol use disorders is relatively low in the Singapore adult population. Comorbidity with mental and physical disorders is significant, emphasizing the need to screen people with alcohol use disorders for these comorbidities.

A Population-based Survey of Mental Disorders in Singapore

Mental illnesses are not only a growing public health concern but also a major social and economic issue affecting individuals and families throughout the world. The prevalence of mental disorders, the extent of disability caused by these disorders, and services utilisation of these patients has been well studied in developed countries. The aim of this study was to establish the prevalence of select mental disorders and their associated sociodemographic correlates in the adult Singapore resident population. This was a cross-sectional, populationbased, epidemiological study of adult Singapore residents aged 18 years and above. The subjects were randomly selected using a disproportionate stratified sampling method. The diagnoses of selected mental disorders including major depressive disorder (MDD), dysthymia, bipolar (bipolar I & II) disorders, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), alcohol abuse and alcohol dependence were established using the Composite International Diagnostic Interview, which is a fully structured diagnostic instrument that assesses lifetime and 12-month prevalence of mental disorders. Among the 6616 respondents (response rate of 75.9%), 12.0% had at least one lifetime affective, anxiety, or alcohol use disorders. The lifetime prevalence of MDD was 5.8% and that of bipolar disorder was 1.2%. The combined lifetime prevalence of the 2 anxiety disorders, GAD and OCD was 3.6%, with the latter being more common than GAD (0.9% and 3.0% respectively). The lifetime prevalence of alcohol abuse and dependence were found to be 3.1% and 0.5% respectively. Age, gender, ethnicity, marital status and chronic physical illnesses were all significant correlates of mental disorders. The identified associated factors would help guide resource allocation, policy formulation and programme development in Singapore.

Rural population survey of behavioral and demographic risk factors for loaded firearms

Objectives—In the United States, firearm deaths are almost as frequent as motor vehicle deaths. Firearm unintentional and suicide death rates are raised in rural areas. This study examines firearm prevalence...

Homeless shelter users in the postdeinstitutionalization era.

To describe the psychiatric symptomatology and mental health service needs of homeless shelter users in Calgary, Alberta. Data were collected as part of a broad-based community action initiative designed to reduce the problem of homelessness. A semistructured interview was conducted with a representative sample of 250 emergency shelter users. Mental health problems were measured through self-reports of 9 psychiatric symptoms known to be related to illnesses prevalent among homeless populations (depression, anxiety, and psychoses). The CAGE alcohol screen was also used. Three-quarters of the sample expressed some symptomatology. About one-third were estimated to have a significant mental health problem. The lifetime prevalence of alcohol abuse was 33.6%. Higher levels of psychiatric symptomatology appeared to relate to a wide range of hardships, personal and public health risks, addictive behaviours, victimization, economic and interpersonal life events, dissatisfaction, and stress. Also, those with significant symptomatology frequently needed mental health care services but often did not know where to access them. The prevalence of mental health and substance abuse problems within homeless populations is significant and associated with considerable hardship as well as personal and public health risks.

Alcohol problems and long-term psychosocial outcome in Chinese patients with bipolar disorder

Background: A high comorbidity of alcohol use disorders among Western bipolar patients is recognized and worsens the outcome of bipolar illness. In view of lower prevalence of alcohol use disorders in some Asian groups, we attempted to investigate the alcohol problems among Chinese bipolar patients in Taiwan. Methods: The clinical data of bipolar patients (DSM–III–R) having been followed-up naturally for at least 15 years were obtained by a combination of chart reviews and interviews with patients and family members. Results: Based on a retrospective chart review of 158 patients, 8.2% of them were found to have alcohol problems. The lifetime prevalence of alcohol abuse was 6.9%, and of alcohol dependence 3.0% among 101 subjects accepting interview. According to the Global Assessment of Functioning Scale ( APA, 1994) nearly one-third of them were clearly dysfunctional. Limitation: As subjects had a greater mean age, the age-related effects probably worsened the psychosocial outcome and reduced the incidence of new substance abuse. Conclusion: Chinese bipolar patients, despite a lower comorbidity of alcohol use disorders, do not have a more favorable long-term psychosocial outcome (marriage, work, and social adjustment) than Western patients.

Lifetime Alcohol Abuse in Institutionalized World War II Veterans

The authors document the lifetime prevalence and etiological correlates of alcohol abuse in a sample of elderly World War II veterans. Subjects (mean age 74.2 years), residing in a veterans' long-term care facility were given the Structured Clinical Interview for DSM-III-R. A second investigator gave the Modified Combat Exposure Scale and administered a checklist of pre-war and wartime variables. The lifetime prevalence of alcohol abuse was 53%. There was no correlation between alcohol abuse and any other psychiatric diagnosis. There was a significant correlation between the severity of combat stress and subsequent alcohol abuse. Veterans with alcohol abuse also had significantly more wartime head injuries. There was also a trend for the alcoholic group to have experienced more pre-war stressors. Examination of pre-war variables and the severity of the combat stress might help to identify veterans at risk for development of alcohol abuse.

South Westminster Schizophrenia Survey

In the context of a prevalence survey of schizophrenia in South Westminster, a questionnaire was administered to 271 patients to assess alcohol-related morbidity. In this epidemiologically based sample, the lifetime prevalence of alcohol abuse was 22.1%. Compared with control patients matched for age and sex, these index cases had a significantly shorter duration of illness. A possible explanation is that drinking may mask the onset of schizophrenia, leading to a delay in diagnosis. The index cases also had significantly higher ratings for hallucinations and for hostility, anxiety and depression, and a greater number of disturbed types of behaviour. The highest levels of alcohol consumption were associated with more severe orofacial dyskinesia, suggesting that alcohol use may be an added risk factor for the development of tardive dyskinesia in some patients. The severity of akathisia was also related to alcohol use, and there were significant relationships between the subjective distress related to akathisia and the level of abuse. A possible interpretation is that alcohol had been used by patients with akathisia to alleviate the associated agitation and dysphoria.