Obsessive Compulsive Drinking Scale Research Articles

Alexithymia in Alcohol Dependence – A Case Control Study from a Rural Tertiary Health Care Center

Background: Alexithymia is a personality trait characterized by difficulty in identifying, expressing, and describing one’s emotions. In recent years, there has been a growing interest in the relationship between alexithymia and alcohol dependence. Several studies have found that alexithymia is more prevalent in individuals with alcohol dependence compared to healthy controls. Objectives: The current research aimed to compare alexithymia between individuals with Alcohol Dependence Syndrome (ADS) and healthy controls among residents of rural India. Additionally, the study sought to assess the association of alexithymia with the duration, severity of drinking, and obsessive-compulsive drinking behaviors. Materials and Methods: A case-control study was conducted involving 49 patients with alcohol dependence and 52 healthy controls in the Psychiatry department of a rural tertiary healthcare center in central India. The Toronto Alexithymia Scale (TAS-20) was utilized to evaluate alexithymia, while patterns of drinking were assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the Obsessive-Compulsive Drinking Scale (OCDS). Results: Significant differences were observed in alexithymia levels between patients with alcohol dependence and healthy controls. Furthermore, alexithymia levels were significantly associated with the duration and severity of alcohol consumption, as well as with the presence of obsessive-compulsive drinking patterns. Conclusion: This study underscores the noteworthy association between alexithymia and obsessive-compulsive drinking behaviors in individuals with alcohol dependence. The findings underscore the importance of addressing emotional difficulties and alexithymia in patients with alcohol dependence.

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...

Predictors of polysubstance use in patients with severe alcohol use disorder: the role of reward craving

BackgroundDifferent craving typologies (i.e., reward, relief, obsessive) have been identified in alcohol use disorder (AUD) but have been less investigated in specific populations like AUD patients with polysubstance use (PSU). The role of dysfunctional personality traits and reward pathways has been reported in both AUD and PSU. We hypothesized that patients with AUD-PSU might show a prevalent reward craving, alongside specific sociodemographic, clinical, and personality features, and aimed at investigating differences in 423 severe AUD outpatients with and without PSU. MethodsOne hundred fifteen patients (27.1% of the sample, 67% males, 42 ± 11.6 years old) displayed PSU. Sociodemographic, clinical features and psychopathological/personality dimensions were assessed through: Craving Typologies Questionnaire (CTQ); Obsessive–Compulsive Drinking Scale (OCDS); UPPS-P Impulsive Behavior Scale (S-UPPS-P); Difficulties in Emotion Regulation Scale (DERS). A binomial logistic regression explored factors associated with PSU. ResultsWe found higher CTQ ‘reward’ scores (p < 0.001) in AUD-PSU patients, and a significant association between reward craving and PSU through logistic regression (OR:1.13; p = 0.005). Earlier AUD onset (p < 0.001), greater rates of binge drinking (p = 0.029), more legal problems (p = 0.015), but no significantly higher S-UPPS-S and DERS scores, were detected in AUD-PSU patients. ConclusionsReward craving was associated with increased risk for PSU in severe AUD patients. Given AUD-PSU participants greater severity and detrimental treatment responses imputed to PSU, identifying prevalent craving types among risk factors for PSU in AUD may help to implement therapeutic strategies. Addressing neurobiological and behavioral mechanisms through combined psychotherapies, pharmacological and neuromodulation treatments could support tailored interventions with better long-term outcome.

Ghrelin and impulsivity relationship in alcohol-dependent patients and healthy individuals.

Abundant research indicates that ghrelin hormone levels are associated with alcohol use and addiction. One of the mediators of this association may be impulsivity, which is one of the common traits observed in alcohol addiction and some eating disorders. This study evaluated participants with alcohol dependency and healthy volunteers to determine whether trait impulsivity and ghrelin levels are associated. This study analyzed trait impulsivity scores and fasting serum ghrelin levels of 44 males with alcohol dependency and 48 healthy male participants. The Barratt Impulsiveness Scale and the UPPS Impulsive Behaviour Scale (UPPS) were used to measure trait impulsivity levels. Penn Alcohol Craving Scale and Yale Brown Obsessive Compulsive Drinking Scale for heavy drinking were used to assess craving at the baseline and after the detoxification period. Alcohol-dependent patients' fasting ghrelin levels were significantly higher than that of healthy participants. Ghrelin plasma levels were positively correlated with UPPS total impulsivity scores and sensation-seeking among healthy individuals. In alcohol-dependent participants, there was a positive correlation between UPPS urgency scores obtained at the baseline and fasting ghrelin levels before and after the detoxification period. Ghrelin-impulsivity relationship could be observed in certain dimensions of impulsivity in both alcohol-dependent and healthy individuals and even independent of the effect of alcohol. Although the associated impulsivity dimensions differ in different groups, the results are parallel to other studies in terms of demonstrating the relationship between ghrelin and impulsivity.

Association between iron accumulation in the dorsal striatum and compulsive drinking in alcohol use disorder

RationaleBrain iron accumulation has been observed in neuropsychiatric disorders and shown to be related to neurodegeneration.ObjectivesIn this study, we used quantitative susceptibility mapping (QSM), an emerging MRI technique developed for quantifying tissue magnetic susceptibility, to examine brain iron accumulation in individuals with alcohol use disorder (AUD) and its relation to compulsive drinking.MethodsBased on our previous projects, QSM was performed as a secondary analysis with gradient echo sequence images, in 186 individuals with AUD and 274 healthy participants. Whole-brain susceptibility values were calculated with morphology-enabled dipole inversion and referenced to the cerebrospinal fluid. Then, the susceptibility maps were compared between AUD individuals and healthy participants. The relationship between drinking patterns and susceptibility was explored.ResultsWhole-brain analyses showed that the susceptibility in the dorsal striatum (putamen and caudate) among AUD individuals was higher than healthy participants and was positively related to the Obsessive Compulsive Drinking Scale (OCDS) scores and the amount of drinking in the past three months.ConclusionsIncreased susceptibility suggests higher iron accumulation in the dorsal striatum in AUD. This surrogate for the brain iron level was linearly associated with the compulsive drinking pattern and the recent amount of drinking, which provides us a new clinical perspective in relation to brain iron accumulation, and also might indicate an association of AUD with neuroinflammation as a consequence of brain iron accumulation. The iron accumulation in the striatum is further relevant for functional imaging studies in AUD by potentially producing signal dropout and artefacts in fMRI images.

The relationship between the clinical characteristics of patients with alcohol use disorder and drinking motives

Changes in the motivational structure are considered one of the central characteristics of Alcohol Use Disorder (AUD). The latest motivational models of AUD were developed based on recent neurobiological research findings. According to these models, three main drinking motives can be identified — drinking as a reward, as a relief, and as a habit. The goal of the study was to explore the main differences in the psychological and clinical characteristics of patients with AUD depending on the predominant drinking motive. For this study, 76 individuals (50 men (65.79 %), average age 42.25 ± 9.36 y. o. (М ± SD)) undergoing in-patient treatment for the symptoms of AUD were recruited. The following methods were used: clinical interview, UCLA Reward, Relief, Habit Drinking Scale, Penn Alcohol Craving Scale, Obsessive Compulsive Drinking Scale, Hospital Anxiety and Depression Scale, Snaith-Hamilton Pleasure Scale, Behavioral Activation Scale/Behavioral Inhibition Scale, and Cognitive Emotion Regulation Questionnaire. The participants were divided into three groups depending on their predominant drinking motive. The participants with the predominant “drinking as a habit” motivation reported using strategies of “refocusing on planning” and “positive reappraisal” significantly less often. At the same time, the intensity of “drinking as a habit” motive positively correlated with the severity of anxiety and depressive symptoms, and negatively — with the strength of the behavioral inhibition system. The participants with the “drinking as a reward” motivation reported having greater reward responsiveness as compared to the combined group of participants with the relief and habit drinking motives. The intensity of “drinking as a relief” motivation positively correlated with the severity of depressive symptoms. It was also noted that the participants, who did not identify the predominant drinking motive, reported having decreased levels of emotional and physical functioning and less frequent use of the certain adaptive emotional regulation strategies. In contrast with the previous studies, the relationship between the prevailing drinking motives and characteristics of drinking or the severity of AUD was not identified.

Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial.

BackgroundAlcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD.Materials and methodsA total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS: left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment: with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse.ResultsThe sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan–Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05).ConclusionThis study is the first to suggest that the combination of rTMS and CBT may be a potentially effective treatment for reducing relapse.

Role of anti-craving drugs baclofen and topiramate in the maintenance of abstinence in alcohol dependence syndrome

Background: Alcohol craving is psychological condition related to motivation. Craving is risk factor for relapse in alcohol dependence syndrome. No gold standard therapy is available; many therapeutic agents are under various evaluation stages. Objectives: To evaluate role of anti-craving drugs baclofen and topiramate in maintenance of abstinence in alcohol dependence syndrome Methods: From March to October 2018, an open-label interventional study with 70 sample size was conducted at Nobel Medical College, following ethical clearance. Age range for inclusion was 20-60, with no history of psychotropic use, whereas history of psychiatric illness and use of substance, excluding nicotine were excluded. After written informed consent patients were admitted for detoxification, and after detoxification, anti-craving therapy was started with topiramate and baclofen and asked for follow-up at two, four, and six weeks. Clinical withdrawal assessment scale was used for withdrawal symptoms and obsessive-compulsive drinking scale (OCDS) for progress in craving. Baclofen at 20 mgs/day, topiramate at 50 mgs/day, were prescribed and increased as required at follow-up. Results: Maximum daily dose of baclofen was 24.29 ± 2.19 mg and topiramate 120 ± 33.21 mg. Baclofen group patients had significant improvement in second week (OCDS T score 16.41± 9.52) while topiramate group showed significant improvement (OCDS T score 17.70 ± 7.57) after four weeks. Major side effects were tremors 8.10% in topiramate group, headache was 5.40% in both groups. Conclusion: Baclofen and topiramate were equally effective at six weeks for controlling cravings. Baclofen started to show significant improvements after two weeks of trial.

Effect of Extract of Black Sticky Rice with Giant Embryo on Alcohol Cravings of Korean Social Drinkers: A 12-Week Randomized, Placebo-Controlled Trial.

We investigated the effect of black sticky rice with giant embryo (BSRGE) extract known to contain high levels of gamma-aminobutyric acid (GABA) on alcohol cravings in social drinkers. A total of 41 subjects were divided into a BSRGE extract group (G group: n = 21) and a placebo group (P group: n = 20), and a randomized placebo-controlled experiment was performed for 12 weeks. The G group took the BSRGE extracts that contained 30 mg of GABA per day. (1) In the Pennsylvania Alcohol Craving Scale, there was a tendency for time and group interaction between the two groups (P = .087) on the total score. (2) In the Obsessive-Compulsive Drinking Scale (OCDS), there was a significance for time and group interaction between the G and P groups (P = .011) on the obsessive subscale. The total score of the OCDS showed significant time and group interactions between the G and P groups (P = .011). Our results showed that the extract of BSRGE containing a high level of GABA significantly reduced alcohol cravings in Korean social drinkers.

Global sleep quality is associated with tonic craving, but not cue-induced craving

ObjectiveSleep disturbance is widespread among individuals with alcohol use disorder (AUD) and is thought to reduce the capacity for self-regulation. The present study examines how sleep disturbance is associated with the regulation of tonic (i.e., “trait-like”) and cue-induced (i.e., “provoked”) craving, among individuals with AUD. MethodsParticipants with an AUD (N = 58) completed the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Obsessive-Compulsive Drinking Scale (OCDS) for tonic craving, and the Alcohol Urge Questionnaire (AUQ) for cue-induced craving during an alcohol cue-exposure paradigm. A series of hierarchical regressions examined the independent contribution of sleep quality to tonic and cue-induced alcohol craving. ResultsPSQI global score was associated with tonic craving per the OCDS, over and above alcohol use and demographic measures. PSQI global score was not associated with cue-induced craving. ConclusionThese findings suggest that sleep dysfunction plays a role in tonic alcohol craving and that the underlying mechanism may be the reduction of self-regulation. Treatments targeting sleep dysfunction in AUD may prove useful in reducing craving and overall alcohol use.

Fluorodeoxyglucose positron emission tomography scans in patients with alcohol use disorder.

Diminished uptake of fluorodeoxyglucose (FDG) has been observed in patients with alcohol use disorder (AUD) but little statistical contrast of the regional brain deficits has been undertaken. This study examined prefrontal cortex inter-regional Brodmann area differences to delineate patterns associated with behavioral, neurotransmitter, and general toxicity hypotheses of cerebral involvement in AUD. We obtained data from FDG positron emission tomography (PET) and anatomical magnetic resonance imaging (MRI) for 87 patients with AUD and 41 age- and sex-matched healthy volunteers. Patients were alcohol dependent and had negative breathalyzer tests at the time of imaging. They were assessed with the Beck Depression Inventory, Alcohol Urge Questionnaire, Obsessive Compulsive Drinking Scale, Spielberger State/Trait Anxiety Scale, Buss-Durkee Hostility Inventory, and the Drinker Inventory of Consequences (DrInC). PET images were co-registered to MRI and both voxel×voxel statistical mapping and stereotaxic regions of interest were obtained. Compared with healthy volunteers, patients with AUD had lower relative metabolic rates in the frontal, temporal, and parietal lobes, localizable most prominently to the dorsolateral and nearly all orbital prefrontal cortex, superior temporal gyrus, and inferior parietal lobule. In contrast, metabolic rates in the medial orbitofrontal and anterior cingulate cortex, and the subcortical structures (thalamus, cerebellum, ventral striatum, and the dorsal raphe nucleus) in patients were significantly greater. The severity of alcohol-related consequences as assessed by the DrInC scale was most highly associated with lower metabolism in the caudate, dorsolateral prefrontal, frontopolar, and anteroposterior cingulate cortex. Despite widespread metabolic abnormalities, decreases in AUD were most marked in frontal executive areas, consistent with diminished impulse control, and increases were most prominent in the striatum and cingulate areas, consistent with a suppressed reward system.

Using Anger Management Virtual Reality Cognitive Behavior Therapy to Treat Violent Offenders with Alcohol Dependence in South Korea: A Preliminary Investigation

Cognitive Behavior Therapy (CBT) effectively treats impulse/anger attacks and aggressive-impulsive behaviors, frequently conducted concerning domestic violence, among patients with alcohol dependence. CBT combined with virtual reality (VR) is a new and beneficial psychotherapeutic intervention for patients and violent offenders with impulse-anger control problems and alcohol dependence. This clinical study evaluated the effects of the “anger management virtual reality cognitive behavior therapy (AM-VR-CBT)” and motivational interviewing (MI) intervention program on quantitative electroencephalography (QEEG) mapping patterns among violent offenders with alcohol dependence (N = 29) in the National Probation Service. A clinical sample of twenty-nine violent offenders with alcohol dependence, who were evaluated and diagnosed with destructive and impulse-control disorders (DICD), underwent AM-VR-CBT combined with MI. The sessions lasted 150 minutes (AM-VR-CBT: 90 min; MI: 60 min) and were conducted twice a week for three weeks (six sessions). The intervention outcomes were measured using advanced QEEG brain mapping and standardized neurocognitive, emotional, and behavioral inventories, including the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), the Readiness to Change Questionnaire (RTCQ), the Barratt Impulsiveness Scale-II (BIS-II), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-Second Edition (BDI-2), and the State-Trait Anger Expression Inventory-2 (STAXI-2), to identify neuro-psycho-physiological changes in violent offenders with alcohol dependence. The Wilcoxon signed-rank test was used at p &lt; 0.05. The intervention showed significant improvements and healthy behavioral changes related to obsessive drinking thoughts, compulsive drinking behaviors, attentional control, intrinsic motivation, worry, anxiety, depression, impulse-anger control issues, aggressive behaviors, over-control, interpersonal relationships, self-efficacy, self-reflection, self-inhibition, creativity, mental navigation/imagery, and episodic memory retrieval among violent offenders with alcohol dependence. Therefore, the results demonstrate the efficacy of the novel and promising clinical evidence-based implementation of the AM-VR-CBT + MI program intervention for non-invasive neuromodulation and related neuro-psycho-physiological, neurocognitive, emotional, and behavioral changes among violent offenders demonstrating alcohol dependence, impulse-anger control, and aggressive behaviors.

Validation and Factor Analysis of the Obsessive Compulsive Drinking Scale (OCDS) in the Chinese Population.

Obsessive Compulsive Drinking Scale (OCDS) was established and introduced to measure the craving for alcohol and the severity of alcohol dependence. However, the Chinese version of OCDS is still unavailable and has not been validated in the Chinese population. We tended to translate and validate the OCDS in Chinese. We translated original OCDS into Chinese through bi-direction translations and tested the reliability and validity. We found that Chinese OCDS had high internal consistency and good test-retest reliability. The Chinese OCDS also presented good internal structure to reflect the severity of alcohol dependence. The Chinese OCDS could be used in clinical studies and research among the Chinese population.

Treating alcohol use disorder in the absence of specialized services \u2013 evaluation of the moving inpatient Treatment Camp approach in Uganda

BackgroundThe gap between service need and service provision for alcohol-related disorders is highest in resource-poor countries. However, in some of these contexts, local initiatives have developed pragmatic interventions that can be carried out with limited specialized personnel. In an uncontrolled treatment study, we aimed to evaluate the feasibility, acceptability, safety, costs and potential effects of an innovative locally developed community-based program (the Treatment Camp) that is based on an inpatient clinic that moves from community to community.MethodsOut of 32 treatment-seeking individuals 25 took part in the one-week Treatment Camp that included detoxification and counseling components. Re-assessments took place 5 and 12 months after their participation. We explored the course of a wide range of alcohol-related indicators, using the Alcohol Use Disorders Identification Test (AUDIT) as primary outcome complemented by a timeline follow-back approach and the Obsessive Compulsive Drinking Scale. Additionally, we assessed impaired functioning, alcohol-related stigmatization, symptoms of common mental health disorders and indicators of family functioning as reported by participants’ wives and children.ResultsAll alcohol-related measures decreased significantly after the Treatment Camp and remained stable up to the 12-month-assessment with high effect sizes ranging from 0.89 to 3.49 (Hedges’s g). Although 92% of the participants had lapsed at least once during the follow-up period, 67% classified below the usually applied AUDIT cutoff for hazardous drinking (≥ 8) and no one qualified for the dependent range (≥ 20) one year after treatment. Most secondary outcomes including impaired functioning, alcohol-related stigmatization, symptoms of depression and indicators of family functioning followed the same trajectory.ConclusionsWe found the Treatment Camp approach to be acceptable, feasible, safe and affordable (approx. 111 USD/patient) and we could obtain preliminary evidence of its efficacy. Due to its creative combination of inpatient treatment and monitoring by medical personnel with local mobility, the Treatment Camp appears to be more accessible and inclusive than other promising interventions for alcohol dependent individuals in resource-poor contexts. Effects of the approach seem to extend to interactions within families, including a reduction of dysfunctional and violent interactions.

Association of executive function, craving and precipitants of relapse in alcohol use disorder: a cross-sectional study

Objective: Alcohol use disorder (AUD) is a global health concern. Patients with AUDs often relapse. Various psychosocial factors, as well as cognitive factors, determine relapse. Failure of response inhibition is often associated with relapse. This study aimed to evaluate the association of craving and relapse precipitants with executive function in AUD.Materials and methods: The study was conducted in the outpatient setting of a tertiary care hospital in North India (between September 2017 to August 2018) on patients with AUD, who presented with a recent relapse. A total of 46 adult patients with AUD, who relapsed after a quit attempt were enroled in the study. Cross-sectional assessment of relapse precipitants (by using relapse precipitant inventory), craving (by using the obsessive-compulsive drinking scale (OCDS)), and executive function (EF) (by using the Wisconsin Card Sorting Test (WCST)) was done along with various socio-demographic and clinical variables.Results: The mean age of onset of alcohol use was 21.48±4.25years and the mean duration of alcohol use was 15.13±7.70 years. The average number of relapses in the study population was 3.59±2.06. There is a significant positive correlation between a negative mood state (as a relapse precipitant) and total relapse score with craving. There is a significant association of relapse and craving with deficits of EF (perseverative and non-perseverative errors). Similarly, lessened cognitive vigilance also significantly correlate with EF deficits resulting in a relapse of AUD. Conclusion: There is a close association of craving, and relapse with deficits of EF, in AUD. Craving and relapse in AUD may be the result of deficits in EF. Future research addressing the cognitive deficits may help in the prevention of craving and relapse.

Associations of NLRP3 and CARD8 gene polymorphisms with alcohol dependence and commonly related psychiatric disorders: a preliminary study.

We investigated two functional polymorphisms in NLRP3 inflammasome genes (NLRP3 rs35829419 and CARD8 rs2043211) and their association with alcohol dependence and related anxiety, depression, obsession-compulsion, or aggression in 88 hospitalised alcohol-dependent patients, 99 abstinent alcohol-dependent participants, and 94 controls, all male Caucasian. Alcohol dependence-related psychiatric disorders were assessed with the Zung Depression and Anxiety scale, Buss-Durkee Hostility Inventory, Alcohol Use Disorders Identification Test, Brief Social Phobia Scale, Obsessive Compulsive Drinking Scale, and Yale-Brown Obsessive-Compulsive Scale. For genotyping we used the allele-specific quantitative polymerase chain reaction-based methods. The three groups differed significantly in CARD8 rs2043211 distribution (P=0.049; chi-squared=9.557; df=4). The NLPR3 rs35829419 polymorphism was not significantly associated with alcohol dependence. In hospitalised alcohol-dependent patients the investigated polymorphisms were not associated with scores indicating alcohol consumption or comorbid symptoms. In abstinent alcohol-dependent subjects homozygotes for the polymorphic CARD8 allele presented with the highest scores on the Zung Anxiety Scale (p=0.048; df=2; F=3.140). Among controls, CARD8 genotype was associated with high scores on the Obsessive Compulsive Drinking Scale (P=0.027; df=2; F=3.744). In conclusion, our results reveal that CARD8 rs2043211 may play some role in susceptibility to alcohol dependence, expression of anxiety symptoms in abstinent alcohol-dependent subjects, and in obsessive compulsive drinking in healthy controls. However, further studies with larger cohorts are required to confirm these preliminary findings.

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.

Alcohol-related changes in behaviors and characteristics from the baseline to the randomization session for treatment and non-treatment seeking participants with alcohol use disorder

ABSTRACT Background Participants who are enrolled in randomized controlled trials (RCTs) may be more motivated to change their behaviors after being enrolled in a study and that motivation may vary by treatment status. Objectives The objectives of this secondary analysis were to investigate if changes in alcohol-related behaviors/characteristics from the baseline to the randomization session differed overall and to assess those differences between non-treatment and treatment seeking individuals with alcohol use disorder (AUD). Methods Our sample included participants from eight RCTs conducted at Brown University (N = 281, 34% female). To assess differences across alcohol-related behaviors/characteristics, we investigated changes in craving (obsessive compulsive drinking scale) and alcohol drinking (percent abstinent days, drinks per week (DPW) and percent heavy drinking days (HDD)) overall and between treatment status. Results Results showed that there were baseline differences, such as increased AUD severity and craving for alcohol in treatment seeking participants (p’s < .05) in the overall sample. Next, we showed that craving, DPW and HDD decreased and percent abstinent days increased from baseline to randomization (p’s < .05). When controlling for treatment status and sociodemographic characteristics, treatment seeking, compared to non-treatment seeking participants, had a greater reduction in alcohol craving (p < .001) and a greater increase in percentage of drinking days (p < .01). Conclusions These findings demonstrated that alcohol-related behaviors and characteristics changed after enrollment. Severity, craving and drinking behaviors also differed between treatment-seeking status, which can potentially impact medication development stages for AUD such as clinical trial eligibility, enrollment and study outcomes.

Clinical characteristics and efficiency of antidepressant therapy of mood disorders with comorbid alcohol use disorder

Aim. To determine the nosological and clinical features of mood disorders (MD) with comorbid alcohol use disorder (AUD) and efficiency of antidepressant therapy. Materials and methods . We examined 88 patients with MD and comorbid AUD – 33 females (37.5%) and 55 males (62.5%). The first group included 31 patients with AUD without comorbid affective symptoms, the second group contained 29 patients with MD without AUD, the third group included 28 patients with AUD and MD. In the study, we applied clinical-psychopathologic, clinical-dynamic, and statistical methods with Pearson’s χ 2 test, Mann – Whitney U -test (for comparison of independent samples), Kruskal – Wallis test (for more than two independent samples), and Wilcoxon test (for comparison of dependent samples). At the level of statistical significance, no differences between the groups according to the gender – age composition were revealed ( p = 0.115 – according to gender composition, р = 0.248 – according to age composition, Pearson’s χ 2 test). Results . The patients with the diagnosis of AUD with comorbid MD showed worse dynamics of the reduction of depressive [from 24.0 (18.3; 33.0) to 9.0 (4.3; 12.0) points according to the Structured Interview Guide for the Hamilton Depression Rating Scale – Seasonal Affective Disorder (SIGH-SAD) ( р = 0.001, Wilcoxon test)] and anxiety [from 20.5 (12.5; 25.0) to 5.5 (3.3; 8.0) points according to the Hamilton Anxiety Rating Scale (HARS) ( р = 0.001, Wilcoxon test)] symptoms against the background of the therapy with initially lower indices compared to the group with MD alone [from 27.0 (21.0; 36.0) to 6.0 (5.0; 11.0) points according to SIGH-SAD ( р = 0.001, Wilcoxon test) (intergroup differences upon admission р = 0.046; upon discharge р = 0.683, Mann – Whitney U -test) and from 21.0 (14.0; 29.0) to 5.0 (3; 10.5) points according to HARS ( р = 0.001, Wilcoxon test) (intergroup differences upon admission р = 0.082; upon discharge р = 0.825, Mann – Whitney U -test)]. The course of AUD is characterized by a larger extent of malignancy in the group with a comorbidity: decrease in pathological alcohol craving from 31.5 (16.3; 43.5) points to 8 (2.3; 14.8) ( р = 0.001, Wilcoxon test) in the group with a comorbidity and from 29.5 (21.8; 37.0) to 7 (3.0; 11.3) points with AUD alone ( р = 0.001, Wilcoxon test) (intergroup differences upon admission р = 0.058; upon discharge р = 0.04, Mann – Whitney U -test on the Obsessive Compulsive Drinking Scale (OCDS). Conclusion. Clinical-dynamic characteristics of MD with comorbid AUD result in therapeutic difficulties associated with comparatively worse dynamics of reduction of the symptoms of both diseases.

Psychological distress, obsessive-compulsive thoughts about drinking, and alcohol consumption in young adult drinkers

ABSTRACT Background Psychological distress is an important predictor of heavy drinking, especially among lower-income drinkers. The mechanisms underlying this effect are not well understood. One possibility is that distressed individuals are more vulnerable to obsessive and compulsive thoughts about drinking. We hypothesized that: 1) distress would predict obsessive and compulsive thoughts about alcohol, which in turn would predict drinking and 2) effects would be particularly pronounced among lower-income drinkers. Methods Young adults (n = 105) were recruited from an urban university and completed the Brief Symptoms Index (BSI), the Obsessive-Compulsive Drinking Scale (OCDS), and a 90-day timeline follow-back (TLFB) drinking interview. Results Consistent with the hypotheses, drinkers with higher distress (BSI) exhibited greater obsessive and compulsive drinking-related thoughts, which in turn predicted drinking over the past 90 days (p < .0001). Path analyses revealed that the BSI had a significant indirect effect on drinking outcomes through increased OCDS. Furthermore, conditional process analyses revealed that effects were particularly pronounced among drinkers with lower household incomes. Conclusions Findings highlight the importance of psychological distress as a predictor of obsessive and compulsive thoughts about alcohol, as well as drinking behavior, and underscore the critical need to address psychological functioning among lower-income drinkers in particular.