Obsessive Compulsive Drinking Scale Scores Research Articles

Relationship between self-stigma about alcohol dependence and severity of alcohol drinking and craving

BackgroundThe correlates and consequences of stigma surrounding alcohol use are complex. Alcohol use disorder (AUD) is typically accompanied by self-stigma, due to numerous factors, such as shame, guilt and negative...

Plasma Orexin Levels Related to Altered Brain Activity During Abstinence in Patients with Alcohol Dependence.

In vivo studies have correlated brain activity with alcohol-seeking behavior, while clinical studies have identified altered brain activity in patients with alcohol dependence (AD) even during abstinence. We aimed to explore the relationship between plasma orexin levels, brain activity, and alcohol-craving scores in patients with AD. In this pilot study, we evaluated 24 male patients with AD in remission and 25 male controls. Alcohol craving was assessed using the Obsessive Compulsive Drinking Scale (OCDS). An adapted MRI technique was used to assess global functional connectivity density (gFCD), and plasma orexin concentrations were measured by radioimmunoassay. Associations were analyzed by the Pearson correlation. Plasma orexin levels in AD patients in remission were significantly higher than those in the controls. OCDS scores correlated to orexin concentrations (r = 0.47, P < .05). Compared to the controls, all AD patients demonstrated reduced gFCD, primarily in the frontal, temporal, and parietal lobes, and increased gFCD in the accumbens nuclei and posterior insular cortex. Mean gFCD values in the accumbens nuclei significantly correlated to craving scores (r = 0.55, P < .05). Although assessed during abstinence, the reward circuits in AD patients exhibited increased activity. Orexin levels correlated to increased activity in the accumbens nuclei and craving scores. The potential clinical utility of plasma orexin levels to assess the risk of relapse in AD patients in treatment and prevention programs deserves further study.

A comparative study on the safety and efficacy of naltrexone versus baclofen versus acamprosate in the management of alcohol dependence.

Background:The efficacy of naltrexone, baclofen, and acamprosate in the treatment of alcohol dependence has been successfully established over the past several years. The knowledge about their relative efficacies can facilitate in developing relapse prevention strategies that would give rise to a greater personal and socioeconomic benefits.Aims and Objective:To assess and compare the safety and efficacy profile of naltrexone, baclofen, and acamprosate in the treatment of alcohol dependence. In addition to this, the pattern of relapse and attitude of patients toward the treatment were also assessed.Materials and Methods:This was a prospective study carried out at a tertiary care center. It comprised of thirty alcohol-dependent patients each assigned to naltrexone, baclofen, and acamprosate group after detoxification. The patients were assessed for craving, relapse risk, and medication adherence using the respective scales and questionnaires.Results:In terms of Obsessive Compulsive Drinking Scale score decline, the decline seen in the naltrexone group (26.72 ± 13.05) was maximum, followed by baclofen and acamprosate. In terms of decreasing Advance Warning of Relapse (AWARE) questionnaire score, again naltrexone was most effective, with the maximum decline in AWARE score (64.72 ± 45.65), followed by baclofen and acamprosate. The attitude toward treatment with all the three medications was positive, as per the Hogan Drug Attitude Inventory score.Conclusion:Naltrexone was most effective in decreasing craving and drinking behavior. Baclofen showed best tolerability in terms of liver function tests and least number of side effects reported. Naltrexone group reported the least number of relapses but maximum number of side effects. Acamprosate group had the maximum dropout rate.

Influence of dopamine-related genes on craving, impulsivity, and aggressiveness in Korean males with alcohol use disorder.

Dopamine is a major neuromodulator that is acutely involved in various cognitive processes, reward-motivated behaviors, and impulsivity. Abnormality in dopaminergic neurotransmission is implicated in the pathophysiology of alcohol use disorder (AUD). The present study examined the genetic influence of dopamine system on problematic drinking, impulsivity, and aggressiveness in a Korean male population with AUD. Five single nucleotide polymorphisms (SNPs) (rs4532 in DRD1, rs2283265 in DRD2, rs6280 in DRD3, rs1800497 in ANKK1, and rs4680 in COMT) and a variable number of tandem repeats (VNTRs) in DAT1 in 295 male patients with AUD were genotyped. For AUD-related clinical characteristics, the Alcohol Use Disorders Identification Test and the Obsessive-Compulsive Drinking Scale (OCDS) were used to assess the severity of hazardous drinking and craving symptoms, respectively. Participants also completed the UPPS-P Impulsive Behavior Scale (UPPS-P) and Buss-Perry Aggression Questionnaire (BPAQ). Analyses were performed using R package SNPassoc; statistical significance was set as p < 0.0083 after Bonferroni correction. A significant association was detected between DRD3 SNP rs6280 and OCDS scores. In regard to impulsivity and aggressiveness, rs4532 of DRD1 was significantly associated with UPPS-P score. Also, rs4532 demonstrated a nominally significant association with BPAQ score, although it did not reach statistical significance after correction for multiple comparisons. Results of this study support the idea that genetic variations in the dopamine system may contribute to alcohol cravings and impulsivity in patients with AUD.

Association of opioid receptor gene polymorphisms with drinking severity and impulsivity related to alcohol use disorder in a Korean population.

AimsRecent evidence suggests that the opioid system is implicated in the pathophysiology of alcohol use disorder (AUD). We aimed to examine the genetic influence of opioid receptors on susceptibility to AUD and its clinical and psychological characteristics including harmful drinking behavior and various aspects of impulsivity in AUD patients.MethodsThree μ‐opioid receptor gene (OPRM1) variants and two κ‐opioid receptor gene (OPRK1) variants were examined in 314 male patients with AUD and 324 male controls. We applied the Alcohol Use Disorders Identification Test (AUDIT), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Dependence Scale. AUD patients also completed the stop‐signal task, delay discounting task, balloon analogue risk task, and the Barratt Impulsiveness Scale version 11 (BIS‐11).ResultsNo significant differences in genotype distributions or haplotype frequencies were found between AUD patients and controls. However, OPRK1 SNP rs6473797 was significantly related to the severity of alcohol‐related symptoms as measured by AUDIT and OCDS and a haplotype containing rs6473797 was also related to OCDS scores in AUD patients. For other psychological traits, OPRM1 SNP rs495491 was significantly associated with scores on the motor subfactor of the BIS‐11.ConclusionGenetic variations in opioid receptors may contribute to symptom severity and impulsivity in AUD patients.

Body mass index and craving predict 24-month hospital readmissions of alcohol-dependent in-patients following withdrawal

ObjectiveAddictive alcohol drinking, craving, and overeating share common etiopathological mechanisms. We investigated whether body mass index (BMI) and craving predict outcome of alcohol-dependent in-patients. MethodThe prospective study included 101 male and 72 female early-abstinent alcohol-dependent in-patients. Craving was quantified by Obsessive-Compulsive Drinking Scale (OCDS) scores. We documented alcohol-related readmissions over 24 months. ResultsIn males, a higher BMI was associated with alcohol-related hospital readmission (median 26.1 vs. 23.1 kg/m2, P = .007) and correlated with more (ρ = 0.286, P = .004) and earlier readmissions (ρ = −0.256, P = .010). These associations were stronger in the subgroup of active smokers (n = 79; median 25.9 vs. 22.3 kg/m2, P = .005; ρ = 0.350, P = .002; ρ = −0.340, P = .002). BMI did not significantly predict outcome in females. Males with at least one readmission reported higher OCDS scores than those without (OCDS-total, OCDS-obsessive, OCDS-compulsive, P < .040), and the OCDS scores correlated with more readmissions (males: OCDS-total, OCDS-obsessive, OCDS-compulsive, ρ > 0.244, P < .014; females: OCDS-compulsive, ρ = 0.341, P = .003) and fewer days to first readmission (males: OCDS-total, OCDS-compulsive, ρ < −0.195, P < .050; females: OCDS-compulsive, ρ = −0.335, P = .004). The OCDS scores explained 9 to 19% of the relationship between BMI and outcome in males. ConclusionBMI and craving are easily accessible outcome predictors of alcohol-related readmission following in-patient withdrawal treatment. They might be used to individualize relapse prevention in the future.

Drop-out, relapse and abstinence in a cohort of alcoholic people under detoxification

The Obsessive Compulsive Drinking Scale (OCDS) was developed to reflect obsessionality and compulsivity related to craving and drinking behaviour for revealing in the long-term drop-out, abstinence and relapse. This study evaluates the early OCDS predictive value in drop-out, abstinence and relapse of patients suffering from Alcohol Use Disorders (AUD) for discovering an OCDS total score cut-off capable of disclosing patients most at-risk of relapse during the beginning of the therapeutic intervention in the Day-Hospital period. The sample includes 263 AUD patients, with 192 men and 71 women. The OCDS scores were measured during the two-weeks Day Hospital treatment for detoxification and after 30, 60, 90 and 180 days after discharge. We also investigated the association between the all OCDS scores and abstinence and between craving, relapse and drop-out. We found that high values of OCDS during Day Hospital detoxification may predict a lower ability to maintain abstinence with elevated relapsing probabilities. Surprisingly, early dropping-out AUD people had lower OCDS total scores. However, significant differences in OCDS values in dropping-out AUD people were revealed mainly 90 and 180 days after discharge compared to no dropping-out AUD subjects. Craving measured also after 30, 60, 90 and 180 days from discharge in AUD relapsers, with OCDS values comprised between 6 and 10, could indicate a lower ability to continue abstinence.In conclusion, OCDS may be a useful tool to early discriminate AUD people at-risk for relapse and drop-out and for addressing the specialist to adjust both medical treatment and psychological support during crucial moments of patients' treatment and follow-up.

Primary psychopathic traits are associated with reduced subjective and cortical reactivity to unpleasant emotional movies

Addictive alcohol drinking, craving, and overeating share common etiopathological mechanisms. We investigated whether body mass index (BMI) and craving predict outcome of alcohol-dependent in-patients.The prospective study included 101 male and 72 female early-abstinent alcohol-dependent in-patients. Craving was quantified by Obsessive-Compulsive Drinking Scale (OCDS) scores. We documented alcohol-related readmissions over 24 months.In males, a higher BMI was associated with alcohol-related hospital readmission (median 26.1 vs. 23.1 kg/m2, P = .007) and correlated with more (ρ = 0.286, P = .004) and earlier readmissions (ρ = −0.256, P = .010). These associations were stronger in the subgroup of active smokers (n = 79; median 25.9 vs. 22.3 kg/m2, P = .005; ρ = 0.350, P = .002; ρ = −0.340, P = .002). BMI did not significantly predict outcome in females. Males with at least one readmission reported higher OCDS scores than those without (OCDS-total, OCDS-obsessive, OCDS-compulsive, P < .040), and the OCDS scores correlated with more readmissions (males: OCDS-total, OCDS-obsessive, OCDS-compulsive, ρ > 0.244, P < .014; females: OCDS-compulsive, ρ = 0.341, P = .003) and fewer days to first readmission (males: OCDS-total, OCDS-compulsive, ρ < −0.195, P < .050; females: OCDS-compulsive, ρ = −0.335, P = .004). The OCDS scores explained 9 to 19% of the relationship between BMI and outcome in males.BMI and craving are easily accessible outcome predictors of alcohol-related readmission following in-patient withdrawal treatment. They might be used to individualize relapse prevention in the future.

The Epigenetic Regulation of GATA4-Dependent Brain Natriuretic Peptide Expression during Alcohol Withdrawal

Objective: Natriuretic peptides participate in the collection of metabolic effects during alcohol withdrawal. Having witnessed modulation of other natriuretic peptides in alcohol-dependent patients during alcohol withdrawal, we were interested in the relation of brain natriuretic peptide (BNP) methylation with protein expression and craving in this longitudinal study. Methods: Ninety-nine male patients were compared to 101 healthy controls concerning epigenetic regulation and protein expression during detoxification treatment. Results: With BNP expression being GATA4 dependent, we observed a correlation of GATA4 binding site methylation and protein expression. BNP serum levels and Obsessive Compulsive Drinking Scale scores are significantly decreased during withdrawal. Focusing on the two CpGs that are between GATA transcription factor binding sites, statistical analysis revealed a reversely proportional methylation pattern, significantly increasing with ongoing detoxification and thereby supporting the observed serum level changes. Conclusion: Without the functional knowledge about regulation of BNP expression via the GATA transcription factor, it would have been easy to take the mean results of the global CpG data and propose a direct relationship between methylation and expression. Thus, these findings are a voice for functionally and mechanistically approved results. There was no causal relationship between protein expression levels and epigenetic changes. Further research is needed which includes protein expression and other approaches.

Differences between treatment-seeking and non-treatment-seeking participants in medication studies for alcoholism: do they matter?

ABSTRACTBackground: Medication development for alcoholism typically includes experimental pharmacology studies with non-treatment-seeking individuals with alcohol use disorder (AUD) paving the way for randomized controlled trials in treatment-seekers with AUD. Objectives: The goal of this study is to provide a direct comparison between AUD treatment-seeking research participants and non-treatment-seeking participants on demographic and clinical variables and to test whether variables that differentiate the two groups are associated with clinical outcomes. Method: Non-treatment-seeking AUD participants (n = 213; 76.3% male) who completed behavioral pharmacology studies were compared to treatment-seekers who completed the COMBINE Study (n = 1383; 69.1% male) on demographic and clinical variables. Analyses examined whether the variables that differentiated the two groups predicted treatment outcomes in the COMBINE Study. Results: Analyses revealed that treatment-seeking participants were older, had more years of education, higher Alcohol Dependence Scale scores, higher Drinker Inventory of Consequences scores, higher Obsessive Compulsive Drinking Scale scores, a greater number of DSM-IV symptoms of AUD, longer duration of AUD, and consumed more standard drinks and more drinks per drinking day (i.e., in the past 30 days) compared to non-treatment-seeking participants. Nearly all characteristics that differed between the groups predicted at least one of the primary clinical outcomes of the COMBINE Study. Conclusions: This study highlights a host of clinical and demographic factors that differ between non-treatment-seeking and treatment-seeking research participants and the clinical significance of these variables. Differences between samples should be considered and addressed in order to promote greater consilience across stages of medication development.

Severity of craving is related with severity of adult ADHD symptoms among inpatients with alcohol use disorder

Objective: The aim of the present study was to evaluate relationship of craving severity with severity of adult attention-deficit/hyperactivity disorder (ADHD) symptoms in a sample of inpatients with alcohol use disorder, while controlling the effects of anxiety and depressive symptoms. Methods: Participants included 78 inpatients with alcohol use disorder. Participants were evaluated with the Obsessive-Compulsive Drinking Scale (OCDS), the Adult ADHD Self-Report Scale (ASRS-v1.1), the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI) after a detoxification period of 3 to 4 weeks. Results: Although trait anxiety predicted OCDS score, trait anxiety was no longer a predictor after entering ASRS-18 score and the ASRS-18 score was the only predictor for severity of craving in linear regression analyses. Results for the ASRS-6 were the same. Among subscales of ASRS-18 inattentive score predicted OCDS score. When obsessive and compulsive dimensions of craving were taken as dependent variables, ASRS-18/ASRS-6 predicted obsessive craving score together with the trait anxiety, whereas ASRS-18/ASRS-6 predicted compulsive craving alone. Conclusion: These findings suggest that severity of ADHD symptoms (particularly inattentive symptoms) is related with severity of the craving. Although ADHD symptoms predicted compulsive craving alone, it predicted obsessive craving together with the trait anxiety. Also ASRS-18 and ASRS-6 showed similar results, suggesting that ASRS-6 with much less items can be used among this population for screening ADHD symptoms.

The association of HTR3A mRNA expression and craving in Han Chinese alcohol-dependent patients: a preliminary study

ABSTRACTBackground: 5-Hydroxytryptamine (5-HT) 3 receptor plays a crucial role in craving of alcohol dependence. Recent evidence shows that chronic alcohol exposure causes changes in gene expression and induces behavioral changes. However, the relationship between gene expression of 5-HT3 receptor and craving in alcohol-dependent patients is not fully understood. Objectives: The aim of this preliminary study was to investigate the relationship between gene expression of the 5-HT3 receptor and craving in alcohol-dependent patients and the epigenetic mechanism. Methods: We recruited 50 male Han Chinese alcohol-dependent patients and 46 male Han Chinese healthy controls. We investigated the changes of HTR3A mRNA, which encodes the 5-HT3 receptor A subunit, and H3K9 acetylation in HTR3A promoter region. Obsessive Compulsive Drinking Scale (OCDS) was used to assess the craving of alcohol-dependent patients relative to controls. Results: HTR3A mRNA expression levels and acetylation levels of H3K9 in the HTR3A promoter region were significantly higher in the alcohol-dependent patients. HTR3A mRNA expression levels were positively correlated with OCDS scores. Moreover, HTR3A mRNA expression levels were positively correlated with acetylation levels of H3K9 in HTR3A promoter region. Conclusion: The current findings suggest that HTR3A mRNA expression levels were positively correlated with craving in Han Chinese alcohol-dependent patients. The regulation of H3K9 histone acetylation in HTR3A promoter region may offer a target for the treatment of alcohol dependence.

The Effect of Varenicline on the Neural Processing of Fearful Faces and the Subjective Effects of Alcohol in Heavy Drinkers.

Pharmacotherapies for alcohol use disorder have been shown to reduce hazardous drinking and improve overall health. The effect sizes for the effectiveness of these medications, however, are small, underscoring the need to expand the range of therapeutics and develop personalized treatment approaches. Recent studies have suggested that varenicline, an α4β2-nicotinic partial agonist widely used for smoking cessation, can help alcoholics reduce drinking, but the neurocognitive underpinnings of its effectiveness remain largely unexplored. In this double-blind study, 32 heavy drinkers were randomized to receive varenicline (2mg/d) or placebo. After 2weeks of dosing, participants underwent functional MRI scans, during which they viewed images of faces with either neutral or fearful expressions at baseline and following an intravenous alcohol infusion to a target breath alcohol concentration of 80mg%. Blood oxygen level-dependent (BOLD) response was analyzed with Analysis of Functional Neuroimaging software. Linear mixed-effects models were used to examine the effects of facial expression (fearful vs. neutral) and medication (placebo vs. varenicline) on BOLD response. The effect of medication on measures of subjective response to alcohol was also examined. Results indicated a significant facial expression-by-medication interaction in the left amygdala. The groups showed equivalent activation to neutral faces, but, whereas the placebo group showed increased activation to fearful faces, the varenicline group showed no change in activation. Amygdala activation to fearful faces correlated with number of drinks in the previous 90days and Obsessive Compulsive Drinking Scale scores. There was no effect of varenicline on subjective response to alcohol. Our results indicate that varenicline may disrupt amygdala response to fearful faces in heavy drinkers. Further, amygdala activation correlated with alcohol consumption, suggesting that the effects of varenicline may be related to aspects of drinking behavior. These results suggest that amygdala response to fearful faces may be developed as a biomarker of the effectiveness of medications being developed for the treatment of alcohol use disorder.

Acceptance and Commitment Therapy in the Treatment of Alcohol Use Disorder and Comorbid Affective Disorder: A Pilot Matched Control Trial

This study examined whether acceptance and commitment therapy (ACT) enhances treatment as usual (TAU) in improving treatment outcomes in patients with alcohol use disorder (AUD) and comorbid affective disorder.Fifty-two participants were included in the study, of whom 26 were patients with AUD and either depression or bipolar disorder treated with ACT group therapy in parallel with TAU (inpatient integrated treatment) and 26 were matched controls who had received TAU alone. Drinking and craving outcomes were total alcohol abstinence, cumulative abstinence duration (CAD) and Obsessive Compulsive Drinking Scale (OCDS) scores at 3 and 6months postintervention. Affective and anxiety outcomes were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Young Mania Rating Scale (YMRS) scores at these follow-ups.Baseline demographic and clinical characteristics were similar in both groups. Retention rates were high: 100% of the ACT group were followed up at 3 and 6months; 92.3% and 84.6% of the TAU alone group were followed up at 3 and 6months, respectively. Patients in the ACT group reported significantly higher CAD at 3 and 6months, significantly lower BDI and BAI scores at 3 and 6months, and significantly lower OCDS scores at 3months, than those who received only TAU. No other significant differences in treatment outcomes were found between the groups.ACT provides added benefit to TAU in improving drinking, craving, depression and anxiety outcomes in patients with AUD and comorbid affective disorder. Most treatment improvements were sustained over a 6-month follow-up period.

Erken ve geç başlangıçlı alkol bağımlılığında dürtüsellik ve karar vermenin değerlendirilmesi

Objective: In this study we aimed to compare impulsivity and decision-making (DM) in early and late-onset alcohol addicts and investigate the relation between impulsivity and DM. Method: In our study, impulsivity and DM were evaluated respectively with Barratt Impulsivity Scale (BIS-11) and Iowa Gambling Test (IGT) in total 55 alcohol addicted male patients, 27 of them were early onset and 28 were late onset. Early and late onset groups were compared in terms of Obsessive Compulsive Drinking Scale (OCDS), alcohol amount that was consumed per day and the family history of alcoholism. Results: While only 33.3% of patients in early onset group were married, the patients in late onset group who were married were found to be 71.4%. There was a history of alcohol addiction respectively in the family of 66.6% of early onset group and of 39.3% of late onset group. In early onset group, attention and motor impulsivity were at more significant level than late onset group. In early onset group; OCDS score were at significant level more than late onset group. It was determined that there is no difference in terms of DM which was evaluated from the early stage to the last stage of IGT. Negative correlation was found between education period and attention impulsivity. Negative correlation was determined at significant level between age of regular alcohol usage, alcohol amount that was consumed per day, attention impulsivity and OCDS. Positive correlation was determined at significant level between alcohol amount which is used per day, attention, motor, non-planning impulsivity and OCDS. Increased amount of alcohol that was consumed per day and high OCDS score are effect attention impulsivity in regression analysis. Increased amount of alcohol that was consumed per day is effects motor impulsivity. Conclusion: While impulsivity in early-onset alcohol addicts is at more significant level than late-onset group, it was determined that there is no difference of DM between two groups.

Predictors of Posttreatment Drinking Outcomes in Patients with Alcohol Dependence

Aim: This cohort study examined how predictors of alcohol dependence treatment outcomes work together over time by comparing pretreatment and posttreatment predictors. Methods: A sample of 274 alcohol-dependent patients was recruited and assessed at baseline, 6 months after treatment initiation (end of the active intervention phase), and 18 months after treatment initiation (end of the 12-month research follow-up phase). At each assessment point, the participants completed a battery of standardized tests [European Addiction Severity Index (EuropASI), Obsessive Compulsive Drinking Scale (OCDS), Alcohol Timeline Followback (TLFB), Fagerström, and International Personality Disorder Examination (IPDE)] that measured symptom severity and consequences; biological markers of alcohol consumption were also tested at each assessment point. A sequential strategy with univariate and multivariate analyses was used to identify how pretreatment and posttreatment predictors influence outcomes up to 1 year after treatment. Results: Pretreatment variables had less predictive power than posttreatment ones. OCDS scores and biological markers of alcohol consumption were the most significant variables for the prediction of posttreatment outcomes. Prior pharmacotherapy treatment and relapse prevention interventions were also associated with posttreatment outcomes. Conclusions: The findings highlight the positive impact of pharmacotherapy during the first 6 months after treatment initiation and of relapse prevention during the first year after treatment and how posttreatment predictors are more important than pretreatment predictors.

Lack of Efficacy of Dextromethorphan in Managing Alcohol Withdrawal

Alcohol withdrawal syndrome is associated with increased central N-methyl-D-aspartate (NMDA) glutamate transmission. Medications that reduce glutamate release or block NMDA overactivation have shown efficacy for treating alcohol withdrawal syndrome. Dextromethorphan (DXM), a widely used antitussive drug, is a low-affinity, noncompetitive NMDA antagonist with potential neuroprotective properties. This study, using a randomized, double-blind, placebo-controlled study design, examined the benefit of DXM in the management of acute alcohol withdrawal. Alcohol-dependent patients admitted for detoxification treatment and experiencing moderate alcohol withdrawal, as measured by a score greater than 10 on the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), were randomly assigned to receive either DXM 360 mg/d or an identical placebo for 7 days in a double-blind manner. All subjects received a concurrent dose of lorazepam 2 mg along with the initial administration of DXM or placebo and were given additional lorazepam (1 mg) as a rescue medication according to the symptom-triggered detoxification protocol. Outcome measures consisted of the mean total dose of lorazepam received, the sequential scores on the CIWA-Ar, and craving assessed by the Obsessive-Compulsive Drinking Scale. Forty subjects completed the study, 18 in the DXM group and 22 in the placebo group. We found that compared with placebo, DXM use was not associated with lower lorazepam doses to control alcohol withdrawal symptoms. The progression in CIWA-Ar and Obsessive-Compulsive Drinking Scale scores was also comparable between the 2 groups. Our preliminary results do not support the efficacy of high-dose DXM in reducing the need of benzodiazepines to treat withdrawal symptoms in alcohol-dependent patients.

A comparative study on clinical effect of Naukan therapy and health education in patients with alcohol dependence

Objective To explore Naukan therapy and health education combined with drug treatment clinical efficacy in the treatment of alcohol dependence. Methods The 66 cases of male alcohol dependent patients were randomly divided into study group (33 cases) and control group (33 cases), and both of patients were taking generic drugs.The study group was given Naukan treatment (including centralized within concept and dispersion Vipassana), and the control group received health education (including collective health education and individual health education). Duration of treatment was 4 weeks, the total number of hours were 55.5 h, 56 h. Obsessive compulsive drinking scale(OCDS), social support rating scale (SSRS), Minnesota multiphasic personality inventory (MMPI) for the two groups before and after treatment; and follow-up the rate of recovery drink three months after hospital discharge. Results ① OCDS score after treatment in the study group was lower than that in the control group, the difference was statistically significant ((48.21±2.05) vs.(54.15±2.01) , t=11.885, P<0.01). ②After treatment SSRS total score, objective support, subjective support, social utilization factor scores were higher than those in the control group, and differences were statistically significant((49.05±5.63)vs.(40.15±6.50), t=5.946, P=0.000); ((14.32±3.51)vs.(8.72±6.22), t=4.504, P<0.05); (27.02±4.26)vs.(19.45±4.92), t=6.682, P=0.000; (10.02±3.30)vs.( 7.52±3.86), t=2.828, P=0.006). ③MMPI with schizophrenia (Sc), paranoia (Pa), mental weakness (Pt), psychopathy (Pd) ie 8/6/7/4 model-based in two groups, and Sc, Pa, Pd, Pt dimensions of the original sub in study group were lower than those in the control group after treatment, in addition to outside Pt differences were statistically significant((25.43±6.76)vs.(29.01±6.72), t=2.158, P=0.035; (14.12±6.01)vs.(18.32±6.42), t=2.744, P=0.008; (18.63±6.85)vs.(23.29±6.12), t=2.342, P=0.022). ④Redrinking rate in study group was 39.39%(11/33), and 72.73%(24/33)in the control group, the difference was statistically significant(χ2=7.44, P<0.05). Conclusion The Naukan therapy combined with general drug treatment can solve the problem of patients with alcohol dependenceof alcohol dependence in the psychological and physiological aspects, and its efficacy is superior to general health education combined drug therapy. Key words: Alcohol dependence; Naukan therapy; Health education; Efficacy

Commentary on Subbaramanet al. (2013): Cravings as a mediator and moderator of drinking outcomes in theCOMBINEStudy

Commentary on Subbaraman<i>et al</i>. (2013): Cravings as a mediator and moderator of drinking outcomes in the<scp>COMBINE</scp>Study

Predictive value of obsessive-compulsive drinking scale (OCDS) for outcome in alcohol-dependent inpatients: results of a 24-month follow-up study

BackgroundThe present study examined whether craving as measured by the obsessive-compulsive drinking scale (OCDS) predict long-term outcome in alcohol-dependent inpatients.MethodsThis was a 24-month prospective, observational study in 198 alcohol-dependent inpatients treated under standardized conditions. The primary outcome criterion was abstinence, defined as no subjective report or objective indication of alcohol consumption since discharge from treatment. The patients self-rated their craving for alcohol at the 6- and 12-month follow-ups by using the German version of the OCDS, which measures obsessive and compulsive aspects of craving. Univariate and logistic regression analyses with covariates were performed.ResultsOf the 104 patients interviewed at the 24-month follow-up, 60% (n = 62) were abstinent. We found significant associations between total OCDS scores at 6 months and outcome at 12 months and between total OCDS scores at 12 months and outcome at 24 months: the higher the OCDS total score at one follow-up evaluation, the less likely patients were to be abstinent at the subsequent one. The same association was found for each of the two OCDS subscales, control and consequences and drinking obsessions.ConclusionsThese results support earlier findings that OCDS scores can predict outcome in alcohol-dependent patients. This information can be used for the timely development of protective resources. Hence, decisions over the use of resources can be made on the basis of objectified parameters to develop a personalized treatment concept. Consequently, economic considerations can induce a reduction of high medical costs.