Prevalence Of Alcohol-related Disorders Research Articles

Korea in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Korea in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

A cross-sectional study to compare levels of psychiatric morbidity between young people and adults exposed to violence in a large urban center.

BackgroundTeenagers and young adults are more exposed to violence and traumatic events than adults, and these factors can be associated with mental disorders. This paper aims at investigating whether young people are more exposed to violence and traumatic events and to compare pattern of mental disorders with adults.MethodsCross-sectional study using the Composite International Diagnostic Interview, conducted between 2007 and 2008 with a randomly selected sample of 15 to 75 year-old residents of São Paulo, Brazil.ResultsTwo thousand five hundred thirty-six participants were divided into two groups: 1096 (43.2 %) young people (15 to 24 years), and 1440 (56.8 %) adults (25 to 75 years). 12-month exposure to traumatic events was higher among young people (32.1 % vs. 20.6 %; p < 0.001). Assaultive violence was reported by 13.4 % of young people and 8.6 % of adults (p = 0.012); 20.1 % of young people and 13 % of adults reported suffering other injury or shocking events (p < 0.001); sudden death/life threatening illness of a close person was declared by 6.1 % of young people and 3.2 % of adults (p = 0.017). Prevalence of alcohol related disorders was higher among young people (5.4 % vs. 2.5 %; P = 0.032); depressive disorders were more prevalent among adults (9.0 % vs. 4.7 %; P = 0.004). Alcohol related disorders were associated to assaultive violence among young people (OR = 3.4; 95 % CI = 1.36 to 8.52; p = 0.004) and adults (OR = 2.38; 95 % CI = 1.23 to 4.61; p = 0.002). Phobic/anxiety disorders were associated to other injury or shocking events among young people (OR = 1.28; 95 % CI = 0.67 to 2.44; p = 0.025). Major depressive disorder was associated to assaultive violence among young people (OR = 2.27; 95 % CI = 1.09 to 4.74; p = 0.004) and adults (OR = 1.28; 95 % CI = 0.85 to 1.93; p = 0.009).ConclusionExposure to violence and traumatic events was higher among young people. Alcohol related disorders, depression and phobic/anxiety disorders were significantly higher among young people exposed to traumatic events. Despite the study design, high exposure to violence and traumatic events in this age group can be considered important factors in triggering mental disorders in this vulnerable age period.

Occupational exposure to solvents: neuropsychiatric and imaging features.

FIGURE 1. A study that compared the prevalence of psychiatric disorders between subjects with chronic solvent encephalopathy (CSE) because of long-term occupational exposure and a matched (age, gender) community sample found that rates were elevated for some disorders and reduced for others, suggesting specificity. The prevalence rates for each psychiatric diagnosis in the CSE subjects (red) and the community controls (green) is illustrated. Note that while the prevalence of several mood and anxiety disorders was higher, the prevalence of alcohol-related disorders was much lower in the subjects with CSE. Unexpectedly, the prevalence of the psychiatric disorders did not differ with effort testing (passed versus failed).

Alcohol drinking rates of male between 7th and 11th graders in Japan decreased gradually based on nationwide repeated cross-sectional surveys from 1996 to 2008

Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school students based on multiple nationwide data. The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from the Japanese Youth Tobacco and Alcohol Surveys, 1996 to 2008. Participants were male 53,925 high school students from 7th grade to 11th grade. We divided to the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades and the end periods were 4 years later in 11th grades. Outcome measures in this study were life time drinking, current drinking within 30 days and weekly drinking. All drinking rates decreased each at 7th and at 11th grade. The increments in these drinking rates from 7th grade to 11th grade in males decreased gradually in recent follow-up groups. Generational impacts should be considered by using follow-up groups to study drinking behaviors among students.

3‐year prevalence of alcohol‐related disorders in German patients treated with high‐potency opioids

In November 2010, the European Medicines Agency's Committee for Medicinal Products for Human Use completed a review of the safety and effectiveness of modified-release oral high-potency opioids (HPO). The reason for this referral procedure was the concern that some of these controlled-release systems may be unstable when co-ingested with alcohol and that the active substance would be released too quickly. The aim of this study was to estimate the prevalence of alcohol-related disorders (ARD) in German patients treated with HPO approved for pain therapy. The source of data was the German Pharmacoepidemiological Research Database including more than 14 million members of four statutory health insurances. The age and sex standardized 3-year prevalence of ARD in patients treated with any type of HPO and in patients receiving modified-release oral HPO was compared with the prevalence of ARD in the general population excluding HPO-treated patients. The age and sex standardized prevalence of ARD was significantly higher in patients treated with any type of HPO (5.5%, 95%confidence interval [CI]: 5.2%-5.9%) or with modified-release HPO (5.4%, 95%CI: 4.8%-5.9%) than in persons belonging to the general population (2.2%, 95%CI: 2.2-2.2%). Interactions with alcohol in patients receiving modified-release HPO may be of relevance in a substantial number of patients. Physicians should be aware of this potentially dangerous interaction.

Diagnostik und Behandlung alkoholbezogener Störungen - Ergebnisse einer repräsentativen Umfrage in Suchtberatungsstellen

Due to the high prevalence of alcohol related disorders (dependent, harmful and at risk drinking) the improvement of the outpatient treatment situation in this area is of major importance. The aim of this study was to examine the treatment structure and modalities of patients with alcohol related disorders in counseling centers for substance abusers based on the questioning of the counselors. A 3-page questionnaire to characterize the institution and six standardized 10-page questionnaires (for the counselors) were sent to all counseling centers (n = 123) in Baden-Württemberg. The counselors were asked about diagnostic and therapeutic procedures they had employed in the last patient seen. Further questions regarded patient related and structural problems. The results are related to a representative sample of 262 counselors of 73 counseling centers (59.5 %). Further 28 counseling centers (22.6 %) were not able to take part in the survey because they do not care for people with alcohol related disorders. The sample complies with respect of relevant dimensions (sponsoring institution, profession of the counselors, age distribution of patients, accomplished interventions) with the population of counseling centers in Baden-Württemberg. The reported patients were predominantly male (80.5 %) and nearly all patients were addicted to alcohol (95.8 %). They had a mean age of 41,9 +/- 10 years, high acceptance of diagnosis (79.2 %) and treatment (80.3 %) and only 6.4 % used multiple substances. The results with respect of the diagnostic procedure refer to a structured, broad and professional procedure. 63.4 % of the counsellors are geared to formal diagnostic criteria when making a diagnosis. All relevant history elements are observed. But the study pointed towards some deficits in recognising suicidal tendencies. The own responsibility related to the supply of people with alcohol problems is predominantly seen in educational advertising and counselling, but also in numerous other areas the own responsibility is judged very high. Further training is particularly seen regarding relapse prevention and suicidality. The co-operation with several institutions, e. g. general practitioners, is judged to be relatively low. The majority of patients described by the counselors were dependent drinkers. This indicates that harmful and at risk drinkers are hardly reached by counseling centers. So there is clear space for optimizing the care for people with alcohol-related disorders.

Alcohol and Drug Dependence: Brain Mechanisms and Behavioral Impact

Substance use disorders follow a dynamic course, which involves cycles of development, maintenance, recovery, and relapse. Dependence on alcohol and drugs develop from chronic use of selective substances that react with, displace, supplant, or alter essential endogenous brain chemistry, and dependence evolves as the exogenous substance is required to replace the dysfunctional endogenous process (Koob and Le Moal 2005). Because addiction has such a firm biological basis, simple removal of the addicting substance can itself be dangerous and cause life-threatening withdrawal effects. The alterations caused by addictive substances are now known to result in structural and functional changes in selective brain systems, depending on the substance. Although improvement in the condition of brain structure and function can occur with abstinence, even safe withdrawal from the substance does not ensure full recovery to all individuals every time they withdraw, the withdrawal process itself may be harmful, and withdrawal does not ensure lifelong sobriety. The problems associated with alcohol and drug addiction are enormous financially and result in untold personal and family strife. It is estimated that approximately 5% of the U.S. adult population is alcohol abusing or alcohol dependent. Although men are more likely to have an alcohol use disorder than women, the prevalence of alcohol-related disorders has increased over the past 10 years, particularly among women and people in the 30 to 65 year range (Grant et al. 2004). Use of illicit substances is also substantial. The National Survey on Drug Use and Health (NSDUH) estimates that in addition to the 15.4 million Americans aged 12 years or older with an alcohol use disorder in 2005, 3.3 million Americans abused or were dependent on both alcohol and an illicit drug, and 3.6 million abused or were dependent on illicit drugs other than alcohol. Of those addicted, only 10% receive any form of treatment. Heightened awareness, improved diagnosis, and reduction of societal stigma would likely reveal that the number of individuals addicted and needing treatment is even higher, the compromise of brain systems more widespread, and the toll on family and community even greater. Multi-front approaches have been resoundingly successful in educating public and family service providers in the diagnosis and treatment of other erstwhile “closet” conditions, such as Alzheimer’s disease, Parkinson’s disease, and autism. Behavior altering agents have been used by humans for at least fourmillennia. Reasons for engaging in substance-induced “mind-altering” experience range from religious to therapeutic to exploratory. Societal disdain of imbibing such substances has had many reasons but commonly has focused on disturbance the imbiber causes—often without personal awareness—to the public and the drain on societal resources resulting from impaired function and productivity. Thus, the “neuropsychological eye” of society recognized cognitive and motor impairment on activities of daily living in the acute drug or alcohol user and even noted the long-term consequences on performance in the chronic substance abuser. Yet, society has seldom looked kindly on “alcoholics” or “drug addicts,” imbuing stigma, discrimination, and a “boot-strap” approach to treatment. Perhaps the grandest scheme ever implemented to eradicate alcohol dependence, Prohibition, considered the “Noble Experiment,” was a decided failure. Neuropsychol Rev (2007) 17:235–238 DOI 10.1007/s11065-007-9039-5

Alcohol-related interventions in general hospitals in Germany: public health and consultation-liaison psychiatry perspectives.

Recent epidemiological studies on substance use disorders in Germany revealed valid estimates of incidence and prevalence of alcohol related-disorders. Alcohol abuse and alcohol dependence are among the most common and frequent diseases in the general population. They have a significant impact on physical as well as on mental health status in more than 75%, and they are associated with a variety of DSM-IV Axis I and Axis II comorbid mental disorders in more than 60% of alcohol-dependent persons [1]. In Germany, about 42,000 persons/year die due to alcohol-related diseases, another at least 14,000/year are accepted for early retirement, and in about 850,000 persons/year alcohol causes periods of inability to work. At least 570,000 admissions to general hospitals/year are related to alcohol problems with an economic impact of EUR 1.9 billion each year [2]. Alcoholism and its common physical and/or mental comorbidity establish many medical and/or psychiatric treatment needs and leads to much higher prevalence rates in the health care system compared to the general population.

Two methods of estimating health costs linked to alcoholism in France (with a note on social costs)

The health costs of alcohol-related problems in France were estimated using two cost evaluation approaches: (1) estimate based on the proportion of cases attributable to alcohol abuse (the alcohol abuse factor); (2) estimate based on prevalence of alcohol abuse for in- and out-patients. For a 10% prevalence of alcohol abuse in the general population, the minimum cost in 1996 was about US$ 2300 million; for a prevalence of 15% it was US$ 2700 million. This cost concerns the health disorders that are linked directly or indirectly to alcohol abuse. It did not allow for injuries from accidents caused by alcohol intoxication and undervalued the cost of out-patient care. Based on the prevalence of alcohol-related disorders seen at hospitals, a percentage of the total in-patient and out-patient costs due to effects of alcohol could be estimated. However, this did not permit an estimate of the cost of care in which alcohol abuse was a risk factor only. Based on the available data showing that between 3% and 10% of inpatients have a directly alcohol-related condition, estimates of in-patient treatment costs varied from US$ 1300 to 2100 million. Among adult out-patients, 20% present with a disorder in which alcohol is a factor or suffer from an alcohol-related illness, which corresponds to a cost of about US$ 1600 million. Thus, these methods yield minimum year's cost estimated between US$ 2500 and 3300 million. These costs are high, compared to the low level of financing for the specialized facilities offering treatment to people in difficulty due to alcohol excess, which was US$ 23 million in that year. As regards social and total costs, estimates from four Western countries have found that about 75% of the total costs of alcohol abuse was attributable to social harm, and 25% to medical costs. Applying this ratio to the French data gives an estimated total cost to French society of about US$ 13 200 million, i.e. 1.04% of the gross national product.

Prevalence of ICD-10 harmful use of alcohol and alcohol dependence among the rural population in Udmurtia.

A sample of 855 rural adult inhabitants in Udmurtia was interviewed by the Composite International Diagnostic Interview 1:1 (CIDI) to investigate the incidence and prevalence of alcohol-related disorders. Harmful use of alcohol and alcohol dependence affected 37.1% of the population according to ICD-10 and DSM-III-R in a lifetime period. The incidence of alcohol dependence in the previous year was 0.8% (1.4% in men, 0.4% in women). Alcohol-related disorders were more common in men (72.6%) than in women (10.3%). Correlates of alcohol dependence were sex (69.3% in men, 3.7% in women), lower education (40.1%) and being divorced in men (77.8%). Alcohol dependence had a high comorbidity with social phobia in Udmurt men and with depression in Russian men.