Prevalence Of Alcohol Use Disorders Research Articles

Alcohol use disorders among Myanmar migrant workers in Thailand

Purpose The purpose of this paper is to determine the prevalence of Alcohol Use Disorders (AUDs) among Myanmar male migrant workers (> 15 years) living in Mae Sot, Thailand, and their patterns of drinking. Design/methodology/approach A cross-sectional survey was administered to 512 participants to measure AUDs and drinking patterns. ANOVA and χ2 analyses were performed to assess demographic differences between abstainers, harmful and hazardous drinkers (HHDs) (those showing signs of AUDs) and non-harmful drinkers. Findings Results showed that 12.3 percent of male Myanmar migrants were HHDs, a rate only slightly higher than in Thai men (9.1 percent), but much higher than in men still living in Myanmar (2.7 percent) (WHO, 2014). Also, 19 percent of alcohol-consuming Myanmar male migrant workers reported patterns of heavy episodic drinking, which is markedly higher than in alcohol-consuming Thai (4.7 percent) and Myanmar men (1.5 percent) (WHO, 2014). Originality/value Given the health risks associated with AUDs and heavy episodic drinking, the findings of this study suggest a need for appropriate alcohol-related health education and intervention for Myanmar male migrant workers.

Management of end-stage alcohol-related liver disease and severe acute alcohol-related hepatitis: position paper of the Italian Society on Alcohol (SIA)

Worldwide, the prevalence of alcohol use disorder (AUD) is 20–30% in men and 10–15% in women, and cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). Thus, the management of ESALD and SAAH in patients affected by AUD may be an essential part of the clinical skills for hepatologists. For these reasons, the national board of the Italian Society on Alcohol have reviewed the most recent data on the management of ESALD, SAAH and LT for ALD in patients with AUD, formulating a position paper with related recommendations regarding four issues of specific clinical interest in this field: (a) the management of hepatic encephalopathy in patients with AUD, and LT in patients with ESALD; (b) the management of SAAH; (c) the management of AUD in patients with ESALD and SAAH; (d) special populations: polydrug addicts.

Problematic alcohol use among fathers in Kenya: Poverty, people, and practices as barriers and facilitators to help acceptance

BackgroundIn Kenya, the prevalence of alcohol use disorder (AUD) is close to 6%, but a notable treatment gap persists. AUD is especially pronounced among men, leading to negative consequences at both individual and family levels. This study examines the experiences of problem-drinking fathers in Kenya regarding previous treatment-seeking related to alcohol use. Experiences and dynamics of the family are also explored as they pertain to treatment-seeking experiences. MethodsIn Eldoret, Kenya, semi-structured qualitative interviews were conducted with 11 families with a male exhibiting problem drinking, his spouse, and one child. Thematic content analysis was used to examine themes related to barriers and facilitators to treatment. ResultsParticipants only reported informal help received from family and community members; they exhibited little awareness of available formal treatments. Families were both deeply affected by alcohol use and actively involved in help-seeking. Indeed, fathers’ experiences are described as help-accepting rather than help-seeking. Three overarching themes emerged from the results: poverty, people, and practices. Poverty could be a motivator to accept help to support one's family financially, but stress from lack of work also drove drinking behaviours. People were also crucial as both barriers and facilitators of help-accepting. Negative help strategies or peer influence deterred fathers from accepting help to quit. Positive motivation, social support, and stigma against drinking were motivators. Practices that were culturally salient, such as religiosity and gender roles, facilitated help acceptance. Overall, most help efforts were short-term and only lead to very short-term behaviour change. ConclusionFamilies and communities are active in help provision for problem-drinking men in Kenya, though results confirm remaining need for effective interventions. Future interventions could benefit from recognizing the role of family to aid in treatment-engagement and attending to the importance of poverty, people, and practices in designing treatment strategies.

Factors Associated With Alcohol Use Disorder Among People Living With HIV/AIDS Attending Art Clinic, Mizan Tep University Teaching Hospital, South West Ethiopia.

IntroductionAlcohol use is a major public health concern in global settings. It is very common among people living with HIV/AIDS, leading to physical and mental complications.ObjectiveTo assess the magnitude of alcohol use and factors among HIV/AIDS positive adults visiting ART clinic at Mizan Tep University Teaching Hospital (MTUTH), Southern Ethiopia from October 2017 to December 2017.MethodsA facility based cross-sectional study was conducted with a sample of 332 HIV positive adults who came to ART clinic at MTUTH using systemic random sampling technique. Data were entered into EPidata 3.1 version and then analyzed by SPSS version 20. Binary logistic regressions have been used to identify the association between an independent variable with the dependent variable.ResultA total of 332 participants were enrolled in the study with the prevalence of alcohol use disorder (AUD) of 18.4%. Factors associated with alcohol use disorder were sex AOR=3.48 (95% CI: 1.27, 9.59), cigarette smoking AOR=5.12 (95% CI: 4.02, 8.61), “khat” chewing AOR=3.23 (95% CI: 2.06.6.89), and CD4 count of 0–200 AOR = 19.49 (95% CI: 1.74, 218.4).ConclusionThe prevalence of alcohol use disorder was high. It is independently associated with male patients, cigarette/tobacco smokers, khat chewers, and low CD4 count.

The epidemiology of alcohol use disorders cross-nationally: Findings from the World Mental Health Surveys

BackgroundPrevalences of Alcohol Use Disorders (AUDs) and Mental Health Disorders (MHDs) in many individual countries have been reported but there are few cross-national studies. The WHO World Mental Health (WMH) Survey Initiative standardizes methodological factors facilitating comparison of the prevalences and associated factors of AUDs in a large number of countries to identify differences and commonalities. MethodsLifetime and 12-month prevalence estimates of DSM-IV AUDs, MHDs, and associations were assessed in the 29 WMH surveys using the WHO CIDI 3.0. ResultsPrevalence estimates of alcohol use and AUD across countries and WHO regions varied widely. Mean lifetime prevalence of alcohol use in all countries combined was 80%, ranging from 3.8% to 97.1%. Combined average population lifetime and 12-month prevalence of AUDs were 8.6% and 2.2% respectively and 10.7% and 4.4% among non-abstainers. Of individuals with a lifetime AUD, 43.9% had at least one lifetime MHD and 17.9% of respondents with a lifetime MHD had a lifetime AUD. For most comorbidity combinations, the MHD preceded the onset of the AUD. AUD prevalence was much higher for men than women. 15% of all lifetime AUD cases developed before age 18. Higher household income and being older at time of interview, married, and more educated, were associated with a lower risk for lifetime AUD and AUD persistence. ConclusionsPrevalence of alcohol use and AUD is high overall, with large variation worldwide. The WMH surveys corroborate the wide geographic consistency of a number of well-documented clinical and epidemiological findings and patterns.

Comorbidity of Lifetime Alcohol Use Disorder and Major Depressive Disorder in San Juan, Puerto Rico

The purpose of this study was to update estimates of comorbidity between lifetime alcohol use disorder (AUD) severity and lifetime major depressive disorder (MDD) in San Juan, Puerto Rico. Data are from a household random sample of 1,510 individuals (816 female) 18-64 years of age in San Juan, Puerto Rico. AUD and MDD identification follow criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and Fourth Edition, respectively, both implemented with the Composite International Diagnostic Interview (CIDI). It is possible to implement DSM-5 AUD identification with the CIDI, but only DSM-IV criteria can be applied to identify MDD. The prevalence of lifetime MDD was 11% among men, 17% among women, and 14% for both genders; the prevalence of lifetime AUD was 38% among men, 16% among women, and 26% for both genders. Among those with AUD, the rate of MDD was 17% among men and 35% among women. Among those without AUD the rate of MDD was 7% among men and 15% among women. Results of multiple logistic regression analysis controlling for gender, illegal drug use, age, level of family cohesion, religion, employment status, marital status, education, and family annual income showed that AUD severity was positively associated with the likelihood of MDD, as follows: mild AUD, adjusted odds ratio [AOR] = 1.78 (95% CI [1.09, 2.91], p < .05); moderate AUD, AOR = 2.58 (95% CI [1.33, 5.01], p < .01); and severe AUD, AOR = 3.34 (95% CI [1.70, 6.56], p < .01). MDD frequently occurs as a comorbid condition with AUD in San Juan, Puerto Rico. The frequency of occurrence increases as AUD severity increases. AUD treatment providers should therefore be equally prepared to treat these two comorbid conditions.

Facilitating Screening and Brief Interventions in Primary Care: A Systematic Review and Meta-Analysis of the AUDIT as an Indicator of Alcohol Use Disorders.

BackgroundThe Alcohol Use Disorders Identification Test (AUDIT) was developed for use in primary health care settings to identify hazardous and harmful patterns of alcohol consumption, and is often used to screen for alcohol use disorders (AUDs). This study examined the AUDIT as a screening tool for AUDs.MethodsA systematic literature search was performed of electronic bibliographic databases (CINAHL, Embase, ERIC, MEDLINE, PsycINFO, Scopus, and Web of Science) without language or geographic restrictions for original quantitative studies published before September 1, 2018, that assess the AUDIT's ability to screen for AUDs. Random‐effects meta‐regression models were constructed by sex to assess the potential determinants of the AUDIT's specificity and sensitivity. From these models and ecological data from the Global Information System on Alcohol and Health, the true‐ and false‐positive and true‐ and false‐negative proportions were determined. The number of people needed to be screened to treat 1 individual with an AUD was estimated for all countries globally where AUD data exist, using a specificity of 0.95.ResultsA total of 36 studies met inclusion criteria for the meta‐regression. The AUDIT score cut‐point was significantly associated with sensitivity and specificity. Standard drink size was found to affect the sensitivity and specificity of the AUDIT for men, but not among women. The AUDIT performs less well in identifying women compared to men, and countries with a low prevalence of AUDs have higher false‐positive rates compared to countries with a higher AUD prevalence.ConclusionsThe AUDIT does not perform well as a screening tool for identifying individuals with an AUD, especially in countries and among populations with a low AUD prevalence (e.g., among women), and thus should not be used for this purpose.

The presence of alcohol consumption prior to homicide in Singapore.

To determine the prevalence of alcohol use disorders in people charged with homicide in Singapore. We also sought to determine which historical risk factors were associated with the use of alcohol 24 h prior to the homicide and with the presence of a severe mental illness at the material time of the offence. We extracted data from administrative records of all people charged with homicide in Singapore between 2007 and 2014. We used regression models to adjust for known confounding variables and explore the relationship between alcohol use and homicide. Of 253 homicide offenders, 141 individuals (56%) meeting criteria for alcohol use disorders at the time of the offence. 121 offenders (48%) consumed alcohol within the 24 h preceding the homicide. Of the 149 that met criteria for a psychiatric diagnosis, 35 had a severe mental illness. Alcohol use disorders are by far the most common disorder diagnosed in people charged with homicide in Singapore. Alcohol use is less common in homicide offenders with SMI.

Implementing alcohol use disorder pharmacotherapy in primary care settings: a qualitative analysis of provider-identified barriers and impact on implementation outcomes

BackgroundDespite the high prevalence of alcohol use disorders (AUDs), in 2016, only 7.8% of individuals meeting diagnostic criteria received any type of AUD treatment. Developing options for treatment within primary care settings is imperative to increase treatment access. As part of a trial to implement AUD pharmacotherapy in primary care settings, this qualitative study analyzed pre-implementation provider interviews using the Consolidated Framework for Implementation Research (CFIR) to identify implementation barriers.MethodsThree large Veterans Health Administration facilities participated in the implementation intervention. Local providers were trained to serve as implementation/clinical champions and received external facilitation from the project team. Primary care providers received a dashboard of patients with AUD for case identification, educational materials, and access to consultation from clinical champions. Veterans with AUD diagnoses received educational information in the mail. Prior to the start of implementation activities, 24 primary care providers (5–10 per site) participated in semi-structured interviews. Transcripts were analyzed using common coding techniques for qualitative data using the CFIR codebook Innovation/Intervention Characteristics, Outer Setting, Inner Setting, and Characteristics of Individuals domains. Number and type of barriers identified were compared to quantitative changes in AUD pharmacotherapy prescribing rates.ResultsFour major barriers emerged across all three sites: complexity of providing AUD pharmacotherapy in primary care, the limited compatibility of AUD treatment with existing primary care processes, providers’ limited knowledge and negative beliefs about AUD pharmacotherapy and providers’ negative attitudes toward patients with AUD. Site specific barriers included lack of relative advantage of providing AUD pharmacotherapy in primary care over current practice, complaints about the design quality and packaging of implementation intervention materials, limited priority of addressing AUD in primary care and limited available resources to implement AUD pharmacotherapy in primary care.ConclusionsCFIR constructs were useful for identifying pre-implementation barriers that informed refinements to the implementation intervention. The number and type of pre-implementation barriers identified did not demonstrate a clear relationship to the degree to which sites were able to improve AUD pharmacotherapy prescribing rate. Site-level implementation process factors such as leadership support and provider turn-over likely also interacted with pre-implementation barriers to drive implementation outcomes.

Patterns of alcohol consumption and alcohol-related harm among European university students.

To compare patterns of alcohol consumption and alcohol-related harm from a survey of university students sampled from universities in Denmark, England, Germany, Italy, Portugal and Switzerland. A total of 2191 university students (70% female, 90% white ethnic group, age range 18-25) completed the survey. Participants completed measures of demographic variables (age, age of onset, ethnic group and sex) and the Alcohol Use Disorders Identification Test (AUDIT), which was the primary outcome. Sixty-three percent of the sample scored negative for harmful drinking on the AUDIT (<8), with 30% categorized as hazardous drinkers, 4% harmful drinkers and 3% with probable dependence. Analysis of variance, including demographic factors as covariates, identified a main effect of country on AUDIT scores F(5, 2086) = 70.97, P < 0.001, partial eta square = 0.15. AUDIT scores were highest in England (M = 9.99; SD = 6.17) and Denmark (M = 9.52; SD = 4.86) and lowest in Portugal (M = 4.90; ° = 4.60). Post hoc tests indicated large effect size differences between scores in Denmark and England and scores in all other countries (0.79 < d < 0.94; all P's < 0.001). European university students in our sample mainly reported low risk patterns of alcohol consumption and alcohol-related harm. However, students from Northern European countries had significantly higher AUDIT scores compared with students from Central and Southern European countries. Research is needed to replicate the present study using nationally representative samples to estimate the prevalence of alcohol use disorders among university students in different European countries.

Predictors of Alcohol Use Disorders in Argentinean Pregnant Women

Background and Objective&#x0D; High prenatal alcohol exposure, such as that presented by women with an alcohol use disorder (AUD), is related to severe adverse consequences such as fetal alcohol syndrome. Since most research on this topic comes from English speaking countries and is scarce in the Argentina, the aim of this study was to identify risk factors of AUD in Argentinean pregnant women. Predictors explored here included drinking alcohol, the use of other substances, and their accompanying motivational and socio-cultural characteristics.&#x0D; &#x0D; Material and Methods&#x0D; A systematic probabilistic sample of 641 puerperal women from an Argentinean city were personally interviewed after giving birth. DSM-5 AUD was established through the International Composite Diagnostic Interview -CIDI-, socio-economic level with the Graffar-Méndez Castellano scale and socio-demographic and psycho-social variables through ad-hoc questions. We then estimated the prevalence of AUD among all women and current drinkers. To identify predictors of AUD we performed logistic regressions with AUD status (positive vs. negative) as the outcome; drinking and substance use variables (age of alcohol consumption onset, usual type of drink, tobacco use during pregnancy, any consumption of other illegal substances), family and living conditions (partner status, previous children, occupation-labor situation, education level, socioeconomic level) and age, the number of health checkups during pregnancy, and general attitude towards alcohol consumption while pregnant, as predictors.&#x0D; &#x0D; Results&#x0D; The prevalence of AUD was 8%, and among current drinkers was 9.5%. The participants’ age, age of alcohol consumption onset, tobacco use during pregnancy, illegal substances use (ever), number of health checkups during pregnancy and general attitude towards alcohol consumption during pregnancy, showed a significant relationship with AUD. As age increased a positive diagnosis of AUD was less likely, while having started to drink before the age of 15 made it more likely. Moreover, if the woman had used tobacco during pregnancy, it was 147% more likely to meet AUD diagnostic criteria, and if she had ever used illegal substances, she was 381% more likely to have an AUD. Finally, a positive diagnosis of AUD was less likely among those who had a negative attitude towards alcohol consumption during pregnancy and among those who had more health checkups during pregnancy. Notwithstanding, in the general model, age, age of alcohol consumption onset and tobacco use during pregnancy were not significant as predictors, which suggests that their relationship with AUD is explained by factors common to the other variables of the model.&#x0D; &#x0D; Conclusion&#x0D; Urgent action is needed in the region to prevent prenatal drinking, and pregnant women with an AUD should be the focus of distinct efforts. Interventions should target younger women, those who consume or have consumed illegal substances and those who maintain a more permissive attitude towards alcohol consumption during pregnancy.&#x0D;

Alcohol misuse among women in Brazil: recent trends and associations with unprotected sex, early pregnancy, and abortion.

Objective:This study compared the rates of binge drinking (BD) and alcohol use disorder (AUD) reported for 2006 with those reported for 2012, exploring their associations with unprotected sex, early pregnancy, and abortion in a representative sample of women in Brazilian households.Methods:This was a descriptive analysis of data from a cross-sectional study involving randomized multistage cluster sampling of the population ≥ 14 years of age. Weighted prevalence rates and odds ratios were estimated, and serial mediation analysis was performed.Results:A total of 4,256 women were analyzed. The BD prevalence was 35.1% and 47.1% in 2006 and 2012, respectively, a significant increase, especially among women 40-59 years of age. There was no significant difference in AUD prevalence. BD (without AUD) was found to increase the odds of unprotected sex and abortion. The path analysis showed that early pregnancy was a mediator of the relationship between alcohol consumption and abortion.Conclusion:Among women in Brazil, the harmful use of alcohol is increasing, which has an impact on female reproductive health and exposure to risks. There is a need for specific prevention initiatives focusing on alcohol-related behaviors in women.

Facilitating Screening and Brief Interventions in Primary Care: A Systematic Review and Meta-Analysis of the Audit as an Indicator of Alcohol Use Disorders

Background: The Alcohol Use Disorders Identification Test (AUDIT) is relatively quick to administer and was developed for use in primary health care settings to identify hazardous drinking and potential alcohol use disorders (AUDs). We aimed to examine the AUDIT as a screening tool for AUDs and alcohol dependence, determine the optimal cut-points and determinants, and apply these cut-points to estimate, by sex and country, the number of people needed to be screened in order to treat one individual with an AUD. Methods: We conducted a systematic literature search for original quantitative studies that administered the AUDIT, identified the prevalence of current AUDs, reported the sensitivity and specificity of the AUDIT by sex, and specified the cut-point(s) used to obtain the respective sensitivity and specificity estimates. Several electronic bibliographic databases (CINAHL, Embase, ERIC, Medline, PsycINFO, Scopus, and Web of Science) were systematically searched for studies published before September 1, 2018, without language or geographic restrictions. We performed cut-point-specific random-effects meta-analyses for both sensitivity and specificity for both sexes, conducted random-effects meta-regression models to determine potential determinants, and estimated true and false positive and true and false negative proportions, as well as the number of people needed to be screened to treat one individual with an AUD. Findings: A total of 36 studies were retained for data extraction. Standard drink size was found to affect the optimal cut-point for identifying AUDs among men, but not among women. The performance of the AUDIT is affected by the prevalence of AUDs; it performs less well in identifying women compared to men, and countries with a low prevalence have higher false positive rates compared to countries with a higher prevalence. Interpretation: The AUDIT does not perform well as a screening tool for identifying individuals with an AUD. Alternative forms of screening should be considered and evaluated for use in primary health care settings. Funding: Funding for this research was provided by the Pan American Health Organization. Declaration of Interest: We declare no competing interests.

Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies

SummaryBackgroundAlthough more than two thirds of the world's incarcerated individuals are based in low-income and middle-income countries (LMICs), the burden of psychiatric disorders in this population is not known. This review provides estimates for the prevalence of severe mental illness and substance use disorders in incarcerated individuals in LMICs.MethodsFor this systematic review and meta-analysis, we searched 17 electronic databases to identify prevalence studies of psychiatric disorders in prison populations in LMICs, published between January, 1987, and May, 2018. We included representative studies from general prison samples, providing information about four major psychiatric diagnoses: psychosis, major depression, alcohol use disorders, and drug use disorders. We pooled data from studies using random-effects meta-analyses and assessed the sources of heterogeneity by meta-regression. We extracted general population estimates from the Global Burden of Diseases 2016 database to calculate comparative prevalence ratios. This study is registered with PROSPERO, number CRD42015020905.FindingsWe identified 23 publications reporting prevalence estimates of severe mental illness and substance use disorders for 14 527 prisoners from 13 LMICs. In this population, the estimated pooled 1 year prevalence rates for psychosis were 6·2% (95% CI 4·0–8·6), 16·0% (11·7–20·8) for major depression, 3·8% (1·2–7·6) for alcohol use disorders, and 5·1% (2·9–7·8) for drug use disorders. We noted increased prevalence at prison intake and geographic variations for substance use disorders. For alcohol use disorders, prevalence was higher in the southeast Asian region than in the eastern Mediterranean region; and drug use disorders were more prevalent in the eastern Mediterranean region than in Europe. Prevalence ratios indicated substantially higher rates of severe mental illness and substance use disorders among prisoners than in the general population (the prevalence of non-affective psychosis was on average 16 times higher, major depression and illicit drug use disorder prevalence were both six times higher, and prevalence of alcohol use disorders was double that of the general population).InterpretationThe prevalence of major psychiatric disorders is high in prisoners in LMIC compared with general populations. As these findings are likely to reflect unmet needs, the development of scalable interventions should be a public health priority in resource-poor settings.FundingCONICYT of the Chilean government and the Wellcome Trust.

Binge eating disorder is not predictive of alcohol abuse disorders in long-term follow-up period after Roux-en-Y gastric bypass surgery.

Some studies have shown an increase in alcohol use disorders (AUD) after Roux-en-Y gastric bypass surgery (RYGB), but its relationship with binge eating disorder (BED) has not been fully explored. The purpose of this study was to determine the prevalence of AUD and BED after RYGB and also to evaluate if BED is predictive of late postoperative occurrence of AUD or BED. Patients (n = 46) submitted to RYGB, in a tertiary outpatient weight management service at a Federal University of Sao Paulo, Brazil, were tested for BED and AUD using the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) and AUDIT, respectively. BED was tested before surgery, while both disorders were evaluated with a follow-up period of 12 ± 1.6years after RYGB. No patients reported AUD before RYBP. After a mean period of 12years from surgery, ten patients (21.7%) were diagnosed with AUD. Before surgery, BED was present in 24 patients (52.2%) and it was detected in seven out of these 24 patients (29.2%) after RYGB. Thirteen new cases of BED (28.2%) were detected after surgery; total of 20 patients (43.5%) with BED. No association was found between pre- and postsurgery BED (p = 0.148). After RYGB, four out of 24 patients (16.6%) with presurgery BED developed AUD, and no association was found between presurgery BED and postsurgery AUD (p = 0.384). Seven out of ten patients (70%) with AUD after RYGB also developed BED, but no statistical significance was found between these two disorders (p = 0.061). The presence of BED before RYGB did not predict AUD and BED after RYGB. Nevertheless, factors involved in a possible association between BED and AUD after surgery remain to be determined. Level III, cohort study.

Interpretation of DSM-5 alcohol use disorder criteria in self-report surveys may change with age. A longitudinal analysis of young Swiss men

Background: General population surveys using self-reported measures show alcohol use disorder (AUD) to be most prevalent in young adulthood, but this may be due to misinterpretations of AUD criteria among inexperienced drinkers. The present study investigated changes in prevalence of criteria during emerging adulthood.Methods: 4924 young Swiss men were followed across three waves (age at wave 1 (w1): 20; w2: 21; w3: 25 years). We measured AUD according to the 11 DSM-5 criteria and estimated Item Response Theory models for each wave and differential item functioning across waves, related to the cohort growing older.Results: Endorsement of several AUD criteria varied considerably as a function of age in a period of only five years: Five criteria showed differential item functioning between waves 1 and 3 (i.e. between the age of 20 and 25), including the three most frequently endorsed criteria. Prevalence of tolerance (w1, 57.8%; w3, 29.6%) decreased in relation to the AUD score (Mantel–Haenszel OR = 0.26), whereas the use of alcohol larger/longer than intended (w1, 73.7%; w3, 84.8%; OR = 1.93) and hazardous use (w1, 62.7%; w3, 68.4%; OR = 1.31) increased, resulting in an unchanged mean AUD score and prevalence, but changing combinations of criteria to qualify AUD.Conclusions: Considerable differential item functioning over five years among several of the most endorsed AUD criteria suggests shifts in the interpretation of DSM-5 criteria during emerging adulthood. Self-reported measures of DSM-5 AUD criteria may require reformulation to account for young people’s different perceptions and to yield comparable diagnoses over time and across age groups.

Treatment gap, help-seeking, stigma and magnitude of alcohol use disorder in rural Ethiopia

BackgroundAlthough alcohol use disorders contribute a high proportion of population disease burden, the treatment gap is large, especially in low- and middle-income countries. To narrow this gap, contextually relevant evidence is needed to inform service development in low- and middle-income country settings. The aim of this study was to assess the magnitude of the treatment gap for alcohol use disorder, help-seeking behavior, stigma and barriers to care among people with alcohol use disorder in rural Ethiopia.MethodsA cross-sectional, house-to-house survey was conducted in Sodo district, south Ethiopia. A sample of 1500 adults was selected using simple random sampling from a census of households and screened for alcohol use disorder using the alcohol use disorders identification tool (AUDIT). Help-seeking, barriers to care and internalized stigma were investigated among people with moderately severe alcohol use disorder (AUDIT score ≥ 16). Poisson regression with robust variance was used to examine factors associated with alcohol use disorder.ResultsThe prevalence of alcohol use disorder (AUDIT ≥8) in the past 12 months was 13.9% (25.8% in men and 2.4% in women, p-value < 0.001). People with alcohol use disorder had increased disability (adjusted prevalence ratio (aPR) 1.03, 95% confidence interval (CI) 1.01, 1.03) and higher depressive symptom scores (aPR 1.02, 95% CI 1.01, 1.04). The treatment gap was very wide, about 87.0% (only 13% sought help) of participants with an AUDIT score ≥ 16 had never sought help for their alcohol problems and 70.0% reported high internalized stigma. Major barriers to seeking help were wanted to handle the problem on their own, believing that it would get better by itself and being unsure about where to go.ConclusionsAlthough alcohol use disorders are common problems in Ethiopian community, the unmet need for treatment is substantial. An integrated care approach has the potential to address this need, but stigma and low awareness may be major barriers to help-seeking. Interventions to reduce stigma and enhance community awareness are recommended.

Alcoholism amongst geriatric patients attending general practice clinic of a Teaching Hospital in Benin City, Nigeria.

Alcoholism or alcohol use disorder (AUD) is common among the elderly, though under-recognised and underreported. This under-reporting is especially so in Africa, including Nigeria where there is near absence of study on the subject matter. This study aims to determine the prevalence of alcoholism amongst geriatric patients at the general practice clinic (GPC) of a teaching hospital and to assess some associated socio-demographic factors. The study was cross-sectional and descriptive, conducted at the GPC of the University of Benin Teaching Hospital, Benin City, Nigeria. Four hundred and twenty-two geriatric outpatients completed the geriatric version of the Short Michigan Alcoholism Screening Test and a socio-demographic data collection sheet. Cross-tabulation of categorical variables was performed by means of IBM SPSS statistics for windows version 19.0, with the level of significance set at P <0.05. The prevalence of AUD was 10.2%; the prevalence amongst males and females was 18.1% and 5.3%, respectively. AUD was present in 14.4%, 6.84% and 4.55% of those who had marital conflict, chronic pain and difficulty with walking, respectively. Sex, age group, financial difficulty, chronic pain and difficulty with walking were significantly associated with AUD. The prevalence of AUD amongst geriatric patients is relatively high. The deleterious effects of alcoholism may be worse in the elderly due to changes that occur with aging and their likelihood to be on medications that may interact adversely with alcohol.

Alcohol use disorders and its association with family factors among undergraduates of obafemi awolowo university, Ile-Ife, Nigeria

Background: Alcohol is a socially acceptable substance that plays a key traditional role in the African setting. Family factors such as dysfunctional family background may increase the risk of alcohol use disorder (AUD) among university students.Objective: This study assessed the prevalence of AUD and its association with family factors among undergraduates of a Nigerian university.Methods: This descriptive cross-sectional survey involved 360 consenting undergraduates recruited from Obafemi Awolowo University, Ile-Ife. Demographic variables were obtained with a questionnaire, whereas AUD was measured with AUD Identification Test. Family factors assessed were family structure, family socioeconomic status, family functioning, parenting styles and perceived social support (PSS).Results: The mean age of respondents was 21.12 years (standard deviation = 2.37) and 223 (61.9%) were males. The prevalence of AUD was 16.7%. Factors significantly associated with AUD were demographic variables – being male (P < 0.001) and traditional religion (P = 0.024) and family factors – low socioeconomic class (P = 0.023), dysfunctional family (P < 0.001) and father use of alcohol (P = 0.001). Respondents with AUD reported significantly lower mean score on all the PSS subscales: family (P = 0.001), friend (P < 0.001) and significant other (P < 0.001) and authoritative parenting style of father (P < 0.001) and mother (P < 0.001). Predictors of AUD were male sex, father use of alcohol, father authoritative parenting style and high PSS from friends.Conclusion: AUD is prevalent among Nigerian undergraduates with male sex and some family factors associated with it. The results of this study have significant implications for both primary and secondary prevention efforts.

A cross sectional study of cognitive impairment in patients of alcohol use disorder attending a tertiary health care center in Central India

Background: Alcohol use disorders (AUDs) have been prevalent among all societies and across the country. In India, the prevalence of AUD in 2010 as reported by the World Health Organization was 2.6% and 1.7% had reported heavy episodic drinking. AUD in India is especially important to watch out for because of consumption of country liquor and high rates of alcohol use in rural population. The aim of the study was to find the relation between AUD and cognitive impairment. Methods: The present study was carried out in the department of psychiatry of a tertiary health-care center and the data were collected from diagnosed cases of AUD. The sociodemographic profile and clinical variables were recorded in specific case report form prepared for this clinical study using Mini-Mental State Examination, Brief Cognitive Rating Scale (BCRS), and Bender Visual–Motor Gestalt Test Second Edition (BG II). Results: Of the 100 patients studied, most were young between the age groups of 18 and 30 (44.0%) years, followed by 31–40 years (40.0%), and 16.0% were above 40 years of age. Most of the patients had a history of alcohol use