Severity Of Alcohol Dependence Questionnaire Research Articles

Sexual Dysfunction, Marital Adjustment, and Quality of Life Among Male Persons with Alcohol Dependence Syndrome Attending Tertiary Healthcare Institution in Northeast India: A Cross-Sectional Study

Background: Sexual dysfunction is one of the major problems associated with the chronic use of alcohol. Sexual dysfunction is also significantly associated with marital adjustment and quality of life. Aim and objectives: To determine the prevalence of sexual dysfunction and its association with marital adjustment and quality of life among persons with alcohol dependence syndrome (ADS) and to compare with the healthy control group. Materials and methods: The present study used a cross-sectional, comparative, and descriptive research design. A purposive sampling technique was used to select the sample of 128 (64 patients with ADS and 64 healthy control persons) between the ages of 21 and 50, from the Department of Addiction Medicine, LGB Regional Institute of Mental Health (LGBRIMH), Tezpur, Assam. Sociodemographic and clinical data sheet, the Arizona Sexual Experience Scale (ASEX), the Severity of Alcohol Dependence Questionnaire (SDAQ), the Alcohol Use Disorders Identification Test (AUDIT), the International Index of Erectile Dysfunction (IIED), and The Drug Abuse Screening Test scales (DAST) were used. Results: The study revealed a higher prevalence of sexual dysfunction in the ADS group (64%) compared to the healthy control group (35.9%) (Chi-square = 46.916; p < .001). Marital satisfaction was significantly lower in the ADS group than in the healthy control group (Fisher’s exact test = 76.932; p < .001). Quality of life was also diminished in the ADS group, particularly in the physical ( t = −5.310; p <.001), social ( t = −4.481; p < .001), and environmental domains ( t = −4.250; p < .001). Furthermore, sexual dysfunction exhibited a significant negative correlation with marital adjustment ( r = −0.676; p < .01) and all domains of quality of life [physical domain ( r = −0.235; p < .001), social domain ( r = −0.383; p < .001), and environmental domain ( r = −0.383; p < .001)]. Conclusion: The prevalence of sexual dysfunction and erectile dysfunction was high in persons with alcohol dependence syndrome as compared to the healthy control group and it has a relationship with marital adjustment and quality of life. The findings highlight the importance of screening and evaluating sexual dysfunction in individuals with alcohol dependence. Comprehensive pharmacological and nonpharmacological services are warranted to address the unique needs of this population, promoting both recovery from alcohol dependence and improvement in overall quality of life.

Sexual dysfunction and marital adjustment in married men with alcohol dependence syndrome.

Only a few studies have systematically assessed sexual dysfunction and marital adjustment in married men with alcohol dependence in India. To assess the prevalence and pattern of sexual dysfunction and marital adjustment in a clinical sample of married men with alcohol dependence. The association of sexual dysfunction and marital adjustment with the severity of alcohol dependence was also explored. This cross-sectional study included 100 consecutive married men attending psychiatry outpatient department (OPD) with a diagnosis of alcohol dependence syndrome (ADS). A pre-designed study proformawas used for collecting relevant socio-demographic and clinical details of the study participants. Sexual dysfunction, marital adjustment, and alcohol dependence were assessed using the following validated tools: the Arizona Sexual Experiences Scale (ASEX), the Marital Adjustment Questionnaire (MAQ), and the Severity of Alcohol Dependence Questionnaire (SADQ), respectively. Of 100 patients, about 15% had clinical sexual dysfunction based on ASEX. The most commonly reported sexual dysfunction was difficulty with erection (24.0%), followed by problems in desire (18.0%), sexual arousal (12.0%), ability to reach orgasm (12.0%), and satisfaction with orgasm (9.0%). Sexual dysfunction (ASEX score) showed significant positive correlation (rs = 0.345; P < 0.001) with alcohol dependence severity (SADQ score). Also, the severity of alcohol dependence was negatively correlated (rs = -0.240; P = 0.016) with the overall level of marital adjustment (MAQ score) with spouse. Sexual dysfunction is common in married men with ADS, with both sexual dysfunction intensity and marital adjustment difficulties being positively associated with the severity of alcohol dependence.

Validation of the Chinese Version of Penn Alcohol Craving Scale for Patients With Alcohol Use Disorder.

The Penn Alcohol Craving Scale (PACS) is a five-item, single-dimension questionnaire that is used to measure a patient's alcohol craving. We sought to develop the Chinese version of the PACS (PACS-C) and assess its reliability and validity. A total of 160 Taiwanese patients with alcohol use disorder were enrolled in this study. The internal consistency and concurrent validity of the PASC-C with the visual analogue scale (VAS) for craving, the Yale-Brown Obsessive Compulsive Scale for heavy drinking (YBOCS-hd), and the Severity of Alcohol Dependence Questionnaire (SADQ) were assessed. The test-retest reliability of the PASC-C was evaluated 1 day after the baseline measurements. Confirmatory factor analysis (CFA) was performed to examine the psychometric properties of the PACS-C. The PACS-C exhibited good internal consistency (Cronbach's α=0.95) and test-retest reliability (r=0.97). This scale showed high correlations with the VAS (r=0.81) and YBOCS-hd (r=0.81 and 0.79 for the obsession and compulsion subscales, respectively), and moderate correlation with the SADQ-C (r=0.47). Furthermore, CFA results revealed that the PACS-C had good fit indices under various models. The PACS-C appears to be a reliable and valid tool for assessing alcohol craving in patients with alcohol use disorder in Taiwan.

A Follow-up Study on Coping Strategies and its Association with Relapse Among Alcohol-dependent Patients.

Alcohol Dependence Syndrome is a chronic illness that is relapsing in nature. Past research has shown that coping strategies that are specific to alcohol dependence are useful in preventing long-term relapse. This follow-up study is, therefore, an attempt to understand the coping styles and strategies that are associated with relapse among individuals dependent on alcohol. We aimed to cross-sectionally assess the severity of alcohol dependence and coping styles of Alcohol dependent individuals. One hundred and twenty-seven consecutive patients who satisfied the International Classification of Diseases Tenth Edition (ICD 10) criteria for alcohol dependence and who were above the age of 18 years were included. This study was conducted in the de-addiction outpatient services of a Tertiary care center in South India between April 2019 and June 2020. Our Institutional Ethical Committee granted the approval for this study. We used a self-designed proforma for collecting the socio-demographic details. The Severity of Alcohol Dependence Questionnaire (SADQ) and Coping Orientation to Problems Experienced Inventory (Brief - COPE) were administered. Patients were followed up for six months. Motivation Enhancement Therapy was given to all our participants during their monthly follow-up visit. Descriptive analysis was performed using mean and standard deviation. We used the student t-test and chi-squared test to understand the differences in the coping strategies between relapsed and non-relapsed persons. Spearman's correlation was used to assess the correlation between the severity of alcohol dependence and coping strategies. A p value of <.05 was taken as significant. Non-relapsed individuals had significantly higher scores on active coping (p = .008), emotional support (p = .044), informational support (p = .017), planning (p < .001), acceptance (p = .030), and humor (p = .001). Relapsed individuals had statistically significant scores on denial (p = .005), substance use (p = .024), and self-blame (p = .012). We found a positive correlation between the severity of alcohol dependence and maladaptive coping strategies (p < .01). Relapsed individuals were found to have significantly higher maladaptive coping strategies. Non-relapsed individuals exhibited greater adaptive coping styles. Maladaptive coping strategies positively correlated with the severity of alcohol dependence.

A CROSS-SECTIONAL STUDY OF PSYCHOSIS AND PERSONALITY PROFILE IN PATIENTS DIAGNOSED WITH ALCOHOL USE DISORDER

Objectives: The objectives of the study are (1) to study personality profile in patients diagnosed with alcohol use disorder (AUD) and (2) to study incidence of psychosis in patients with AUD. Methods: This was a cross-sectional study conducted in the department of psychiatry of a tertiary care medical college. 70 patients presenting with a history of alcohol intake underwent diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for AUD were enrolled in the study on the basis of pre-defined inclusion and exclusion criteria. Post a 2-week detoxification period, psychiatric symptoms encompassing depression, anxiety, hallucinations, and unusual behavior were assessed using the brief psychiatric rating scale (BPRS), while personality profiles were evaluated with the NEO Personality Inventory-3. Alcohol dependence levels were measured using the Severity of Alcohol Dependence Questionnaire. Results: There were 60 (85.71%) males and 10 (14.29%) females. There was a significant male preponderance in studied cases with M:F ratio of 1:0.16. Highest number of patients, i.e., 63 (90%) patients were married, followed by 4 (5.71%) patients were unmarried and 3 (4.29%) patients were divorced. Among 70 studied cases, 5 (7.14%) patients were found to have some or the other degree of psychotic symptoms. There was a significant correlation between being unskilled worker and having low literacy or low income and AUD (p&lt;0.05). There was no statistically significant association between severity of AUD and education (p=0.70), occupation (p=0.94), income (p=0.84), and family history of alcohol consumption (p=0.58). Participants have mild severity shown low to average score on neuroticism, average scores on extraversion, very low to low scores on openness, high to very high scores on agreeableness, and high to very high scores on conscientiousness. Conclusion: We found a significant correlation of AUD with increasing age, male gender, early alcohol initiation, and prolonged dependence. Lower education and unskilled occupations were also linked to AUD. Personality trait analysis revealed distinct patterns based on the severity of physical dependency.

Study of Association of Erectile Dysfunction in male subjects with the severity of Alcohol Dependence

Background: Alcohol dependence syndrome is a major public health problem, and it impacts the social, psychological, medical, economic, and religious spheres of our existence. Persistent alcohol abuse impacts sexual functioning negatively and leads to the onset of sexual dysfunction. Aim: This study was conducted to determine erectile dysfunction in males diagnosed with alcohol dependence syndrome and its association with the severity of alcohol dependence. Materials and Methods: The descriptive, non-interventional, cross-sectional study was conducted at the Department of Psychiatry in a tertiary care hospital where 78 subjects diagnosed with alcohol dependence syndrome were assessed for severity of dependence with the Severity of Alcohol Dependence Questionnaire (SADQ-C). Erectile dysfunction in these subjects was assessed with the International Index of Erectile Function scale (IIEF) and the severity of the same was correlated with the severity of alcohol dependence. Results: The results of our study indicated that erectile dysfunction was common in individuals having alcohol dependence syndrome and its severity was positively correlated with the severity of alcohol dependence. Unidentified sexual dysfunction may perpetuate alcohol dependence with poor response to deaddiction therapy. This information about sexual dysfunction due to alcohol dependence can also be used in motivational counseling of heavy drinkers to provide an impetus for change. Conclusions: The prevalence of erectile dysfunction was significantly higher than that of the general population. The same was significantly elevated in patients with severe alcohol dependence as compared to those with mild/moderate alcohol dependence.

Prevalence of alcohol dependence syndrome in the patients of acute pancreatitis: A cross-sectional study.

Acute pancreatitis (AP) is the main reason for mortality and morbidity. Numerous studies have shown a link between chronic alcohol usage and AP. However, there are few studies on the percentage of patients developing AP as a result of dependent patterns of drinking and associated risk factors. This study aimed to study the prevalence and impact of risk factors of alcohol dependence syndrome with AP patients hospitalized in tertiary care facilities. This is a cross-sectional observational study. Sociodemographic and clinical data were taken from patients with AP after consent. Eighty-five patients with AP who met the inclusion criteria were involved after each participant had clinical evaluation using the modified Marshall score, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire (SAD-Q). The outcomes were tabulated and analyzed using Statistical Package for the Social Sciences (SPSS) software. 38.8% of patients with AP were found to have features of alcohol dependence syndrome. Higher values of mean corpuscular volume (MCV), serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), Gamma-glutamyl transferase (GGT), and uric acid were associated with a greater propensity to have AP. The severity of alcohol dependence syndrome and AP was not associated. AP is potentially a fatal disease. In this study, 38.8% of AP patients had alcohol dependence syndrome. There was no statistical association between the severity of AP and alcohol dependence syndrome, though high values of MCV, SGOT, SGPT, and GGT were at greater risk of developing AP. As a result, alcohol dependence syndrome should be examined in all individuals with AP.

Alcohol-associated sexual dysfunction: How much is the damage?

BackgroundThe existing literature on alcohol-induced sexual dysfunction has mainly deliberated on erectile dysfunction and premature ejaculation, ignoring other important domains of sexual dysfunctions (viz sexual pleasure, sexual desire, arousal, orgasmic function). This study was undertaken to assess the extent of alcohol-associated sexual dysfunction and to compare their severity with the severity of alcohol dependence in males. MethodsA cross-sectional descriptive study design recruited 78 male patients and an assessment was conducted using the Changes in sexual functioning questionnaire male clinical version, International index of erectile function scale, Severity of Alcohol Dependence Questionnaire, Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and International Classification of Diseases-10 (ICD-10). A correlation between years of alcohol consumed and its effect on various domains of sexual dysfunction was also carried out using Pearson's correlation coefficient. ResultsSeventy-seven percent of the study population had complaints of sexual dysfunction in one or more domains, with reduced sexual pleasure (71.8%) as the most common followed by low sexual desire (in terms of frequency) in 61.5% and erectile dysfunction in 43.6%. The severity of the sexual dysfunction was found to be directly proportional to the severity of alcohol dependence with almost 100 percent of the patients with severe alcohol dependence having sexual dysfunction in all the domains. ConclusionThe most common sexual dysfunction reported in the current study was decreased sexual pleasure (71.8%) followed by low sexual desire 61.5% (in terms of frequency). These findings emphasize the fact, that alcohol significantly compromises almost all domains of sexual functioning in addition to erectile dysfunction.

Extent and Severity of Internet Addiction in Persons with Common Mental Disorders

Abstract Background: There is a scarcity of literature about Internet addiction (IA) in common mental disorders (CMDs) such as depression, anxiety, obsessive-compulsive disorder, and substance use disorders. Early identification of IA in CMDs can help in better management of both disorders. Aims: To assess the extent and severity of IA in persons with CMDs. Methodology: This was a cross-sectional, single-group, exploratory study conducted at the Department of Psychiatry of tertiary care teaching hospital in North India. Patients aged 18 years and above and diagnosed with CMDs (Neurotic and stress-related disorders, Depressive Disorder, and substance use disorder) as per the ICD-11 criteria were included in the study after taking written informed consent. The severity of CMDs was assessed on Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Yale-Brown Obsessive-compulsive Scale, Severity of Alcohol Dependence Questionnaire and Severity of Opioid Dependence Questionnaire. The level of IA was assessed using Young’s IA Test. Results: A total of 150 patients diagnosed with CMDs were included. Males were slightly more than females (56% v/s 44%), most were younger than 40 years of age (55.3%), married (66.7%) and from urban (65.3%) background. Out of 150, 84 (56%) had depressive disorder, 45 (30%) had anxiety disorder, 15 (10%) had OCD and only 6 (4%) had substance use disorders. 69 (46%) participants had IA (36 mild and 33 moderate) and none had severe IA. A significant association was found between IA and CMDs (P &lt; 0.05). Age, marital status, and type of residence were independent predictors or risk factors for IA. Conclusion: The index study concludes that there is a strong association between CMDs and IA. About half of persons with CMDs have IA.

Alcohol dependence syndrome in patients with alcoholic liver disease: A cross sectional observational study.

Excessive alcohol use leads to a spectrum of liver disease. While physicians treat liver disease, the cause, i.e. alcohol, often remains untreated. This portends a poor overall outcome as such patients may continue to consume alcohol for the want of appropriate treatment directed at alcohol dependence or abuse. To assess the prevalence and severity of alcohol dependence among patients with Alcoholic Liver Disease (ALD). A cross-sectional observational study was conducted among patients with varying severity of ALD (steatosis, hepatitis, and cirrhosis) where 75 were included. They were evaluated for alcohol dependence using clinical interview and M.I.N.I 6.0. The severity of dependence was rated using the SADQ (Severity of Alcohol Dependence Questionnaire). Appropriate statistical tests were applied to identify correlations. All the patients of ALD met the criteria of Alcohol Dependence Syndrome (Clinical interview and ICD 10 criteria). Among them, 40% were severely dependent (SADQ >30). Among those with ALD, 57.3% had alcoholic hepatitis, 18.7% had steatosis, and 24% suffered cirrhosis. Patients with cirrhosis had higher median SADQ scores compared to those with steatosis or hepatitis. All the patients with ALD suffered from Alcohol Dependence Syndrome. Those with the most severe ALD had a higher severity of dependence. To ensure effective treatment and lasting outcomes, there is a need for greater awareness of this fact among physicians. Psychiatric referral of those suffering from ALD will ensure concurrent treatment of Alcohol Dependence Syndrome.

Serum BDNF Levels Among Patients with Alcohol Dependence, Depression and Alcohol Dependence with Comorbid Depression – A Comparative Study

ABSTRACT The study aimed to assess and compare the serum brain derived neurotrophic factor (BDNF) levels in patients with alcohol dependence, depression and alcohol dependence with comorbid depression. Three groups each of 30 alcohol-dependent, depressive and alcohol-dependent with comorbid depressive patients seeking treatment were included. BDNF levels were estimated, and scales were administered to assess severity of alcohol dependence (using severity of alcohol dependence questionnaire, SADQ) and depressive symptoms (using Hamilton depression rating scale, HDRS). The mean BDNF value in ADS, depression and ADS with comorbid depression group was 16.4 ng/mL, 14.4 ng/mL and 12.29 ng/mL respectively, and the differences were statistically significant. In ADS group and ADS with comorbid depression groups significant negative association existed between BDNF and SADQ scores (r = −0.371, p = .043 and r = −0.0474, p = .008 respectively). There were significant negative association between BDNF and HDRS scores in depression and comorbid ADS and depression group (r = −0.400, p = .029 and r = −0.408, p = .025 respectively). The BDNF level was significantly lower in the ADS with comorbid depression group and was associated with severity of dependence and depression across the groups.

A prospective study of amelioration of cognitive functions following alcohol abstinence in patients with alcohol dependence syndrome

Abstract Background: Increased intake of alcohol causes changes in the cognitive process, affecting many important functions such as execution, recent memory, and visuospatial abilities. Sometimes changes imparted by alcohol use are irreversible. Aims and Objectives: The impairments caused by alcohol abuse are usually underdiagnosed even though they are moderate to severe. To this purpose, we studied the cognitive improvement on abstinence of alcohol use. Materials and Methods: The present study was done in 100 patients, whose diagnosis was made as per the International Classification of Disorders-10 as alcohol dependence syndrome. Patients were administered with the scales, the Severity of Alcohol Dependence Questionnaire (SAD-Q), Montreal Cognitive Assessment, Postgraduate Inventory Battery of Brain Dysfunction (PGIBBD), Trail Making Test-B, Digit Span Test, and Digit Vigilance Test. The evaluation of patients was done after 2 weeks of the last alcohol intake and reassessed at the end of the 3rd and 6th months, scores were compared. Analysis of data was done by using mean and standard deviation for continuous variables. The categorical variables were presented as frequency and percentages, and the comparisons between the quantitative data were done by analysis of variance test. Results: The cognitive assessment revealed impairments in executive function, short-term verbal memory, recent memory, visuospatial abilities, visual recognition, and processing speed on initial evaluation, and all the values improved in 6 months of abstinence. Conclusions: In this study, we found, there was significant impairment in memory, executive function, processing speed, visuospatial and recognition skills, initially, and improvement in cognitive function in alcohol.

Impulsivity in Alcohol Dependence among Male Patients in Tamil Nadu: A Cross-sectional Study

Introduction: Alcohol is one of the major substances used in our country, affecting people of young age to old age. It has become a significant concern as a public health burden across all of India. Although the consequences of alcohol dependence in terms of impulsivity are widely assessed, the depth of the burden of alcohol dependence changes with respect to place, time, and socio-economic conditions. Aim: To understand the role of impulsivity and Adverse Childhood Events (ACE) in alcohol dependence among male patients. Materials and Methods: A hospital-based cross-sectional study was conducted between January 2020 and December 2020 among 190 male cases of alcohol dependence syndrome based on ICD-10 criteria. These patients visited the outpatient or inpatient psychiatry department at SRM Medical College Hospital and Research Centre, Potheri, Chengalpattu, Tamil Nadu, India. During the first visit, socio-demographic and clinical details were collected, along with the Barratt Impulsiveness Scale (BIS) and ACE Questionnaire. During the second visit, the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Scale and Severity of Alcohol Dependence Questionnaire (SADQ) scales were used. Pearson’s correlation was used for analysis using statistical software Statistical Package for Social Sciences (SPSS) version 21.0. Results: Out of the 190 patients enrolled in the study, the majority had completed middle school level education (34.2%). Among the alcoholics, 63.7% were married, and approximately 73.2% were from the lower and middle socio-economic class. A family history of alcoholism was found in nearly 78% of the participants. The maximum number of participants had 1-3 months of abstinence. Pearson’s correlation showed a positive correlation between impulsivity and its subscales with alcohol dependence score and ACE (p&lt;0.05). Conclusion: This study concludes that both impulsivity and alcohol dependence have a bidirectional relationship. ACE also has a positive relationship with impulsivity and alcohol use.

A Study of Psychological Impact on Adolescent Children of Parents with Alcohol Use Disorder

Abstract Context: Children of alcoholics face risks of problem behavior during childhood and mental health problems in adult life. Identifying these problems at the earliest can significantly reduce the problems in future. Aim: We aimed to study psychological impact on adolescent children of parents with alcohol use disorder. Settings and Design: This is a cross-sectional study done at a tertiary care hospital in Maharashtra. Materials and Methods: Convenience sampling technique was used. One hundred adolescent children of alcohol use disorder patients were evaluated for problem behavior and perceived stress using the Child Behavior Checklist (CBCL) and Perceived Stress Scale, respectively. Current status of severity of alcohol use in parents was assessed using the Severity of Alcohol Dependence Questionnaire. Statistical Analysis Used: Data were analyzed using the Statistical Package for the Social Sciences Software Package (version 20.0). Results: In our study, we found that children whose fathers had severe alcohol dependence were exhibiting more externalizing behavior on CBCL and higher perceived stress and it was statistically significant. Conclusion: A positive correlation was found between severity of alcohol use in fathers and problem behavior in children.

An observational study on deliberate self-harm in individuals with alcohol dependence syndrome.

Comorbidities in alcohol dependence syndrome (ADS) are often associated with poor treatment outcomes and high service utilization. Deliberate self-harm (DSH) in India is a silent epidemic. There is a shortage of research on individuals with ADS, psychiatric comorbidities, and DSH. To study DSH and psychiatric comorbidity in persons with ADS. A cross-sectional study of 1-year duration is conducted in out patient department/indoor patient department of a tertiary care hospital. Eighty-one individuals with ADS were selected purposefully. A semi-structured pro forma, the severity of alcohol dependence questionnaire, Mini-International Neuropsychiatric Interview (MINI), and Deliberate Self-Harm Inventory were administered for assessment. The statistical analysis used is as follows: correlation statistics and logistic regression. Most subjects were married, belonged to upper-middle socioeconomic status, had at least secondary education, and had moderate alcohol dependence severity. Almost 3/4th of the subjects had at least one lifetime psychiatric disorder. A past episode of major depressive disorder was found in 47%. Nearly 20% of study subjects had a history of DSH, which was significantly associated with unmarried status, and earlier age of alcohol dependence. Marital status, educational level, and age of onset of alcohol dependence explain 64.3% of the variance in DSH attempts. Suicidality was significantly related to the presence of DSH. The study found a high prevalence of psychiatric disorders and a history of DSH in individuals with ADS. The study confirmed the association between DSH and suicidality and indicated a specific subpopulation of ADS who need thorough clinical assessments to recognize these psychiatric comorbidities and DSH.

Insufficient Physical Activity Is a Global Marker of Severity in Alcohol Use Disorder: Results from a Cross-Sectional Study in 382 Treatment-Seeking Patients.

Improving physical activity (PA) in patients with alcohol use disorder (AUD) has recently emerged as an important component of the global treatment strategy to improve drinking outcomes and quality of life. However, this new approach should focus on AUD patients with insufficient baseline PA and requires this subgroup to be better characterized. In a population of 382 treatment-seeking AUD patients, PA was assessed using the International Physical Activity Questionnaire, and participants were divided into two groups: insufficient PA group and sufficient PA group. The severity of the AUD was assessed using the DSM-5 criteria, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire. In logistic regression models, individuals with insufficient PA were more likely than other AUD individuals to present a higher Body Mass Index (p < 0.001), a higher number of AUD DSM-5 criteria (p < 0.05), more frequent opioid use (p < 0.05), higher scores at the Fagerström Test for Nicotine Dependence (p < 0.001), State-Trait Anxiety Inventory (p < 0.001), impulsivity scale (p < 0.05), Pittsburgh Sleep Quality Inventory (p < 0.05), and lower WHO Quality of Life (p < 0.001) scores. In AUD, an insufficient baseline PA is associated with several markers of severity, and physical exercise interventions should be part of a multimodal treatment program integrating the global impairments of patients.

Determinants of Treatment Outcome, Follow-Up, and Abstinence Rates Among Patients With Alcohol Use Disorder: A Prospective Study.

Background The treatment of alcohol use problems needs to have a multidimensional approach for early recovery and better outcome. Objective The study aimed to study the socio-demographic, clinical, and psychological factors associated with the three-month clinical outcomes among patients with alcohol use disorder treated in a tertiary care general hospital psychiatric unit in southern India. Methods This is a prospective three-month follow-up study. Patients fulfilling the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for alcohol use disorder were selected for the study. The baseline severity of alcohol use was assessed by the Severity of Alcohol Dependence Questionnaire, alcohol craving by Alcohol Craving Questionnaire (ACQ), impulsivity by Barratt Impulsiveness Scale, anxiety and depression by Hospital Anxiety and Depression Scale and personality traits by Personality inventory for DSM-5. Craving was assessed at 2, 4, 8 and 12 weeks post-discharge. Results A total of 110 patients participated in the study. After 3 months of follow-up, 75.5% of the patients remained abstinent throughout the follow-up period. The sample was divided into two groups based on the abstinent status at 12 weeks. Both the abstinent and relapsed users were compared based on socio-demographic, marital, family, illness-related, alcohol-usage, and psychological characteristics, the baseline and follow-up craving indices. There were no statistically significant differences between the two groups based on socio-demographic characteristics. Compared to the relapsed group, the abstinent individuals displayed increased adherence to follow-up visits and attended more frequent individual therapy sessions, however, there were no significant differences between the two groups in the number of group therapy sessions attended.Also, the abstinent group demonstrated lower subjective craving at both the baselineand during follow-up. The relapsed users had reported a significantly greater proportion of history of suicide in the family. Further correlational analyses were done to find the direction of associations between psychological characteristics and alcohol-usage characteristics. High attentional impulsivityand motor impulsivitywere associated with early age of first use. High attentional impulsivity, motor impulsivityand impulsive planningwere associated with early age of dependence. Early age of dependence was associated with increased levels of antagonism and psychoticism. Younger onset of alcohol use was associated with increased levels of craving at baseline. The baseline alcohol use severity and the baseline craving towards alcohol were positively correlated with follow-up craving indices as per ACQ and craving index (CI) scales. Conclusion The patients who were abstinent displayed reduced subjective craving towards alcohol at baseline and were more adherent in attending individual and group therapy sessions. Among the relapsed users, most relapsed before four weeks and had a family history of alcohol dependence, family history of psychosis, and suicide, which is indicative of high genetic loading of substance abuse leading to early initiation and early onset of alcohol dependence. The effects of genetic loading could be possibly mediated by traits of high impulsivity, psychoticism, and antagonism.

A STUDY ON EVALUATION OF SEXUAL DYSFUNCTION IN MALE PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME IN A PERIPHERAL TERTIARY CENTRE OF KARNATAKA

Background: Conicting to the popular belief concerning the erogenous effects of alcohol, there exists scientic evidence which conclude on sexual dysfunction caused by chronic alcohol use, which leads to marked distress and interpersonal difculty. Aim: To estimate the relationship between sexual dysfunction in male patients with alcohol dependence syndrome. Materials and Methods: The study employed a cross-sectional descriptive design and recruited 47 male patients who came for de-addiction in a tertiary care centre. The evaluation was conducted using a specially designed intake proforma and tools such as Severity of Alcohol Dependence Questionnaire, Arizona Sexual Experience Scale, and International Classication of Disease 10 DCR. Results: 74.5% of the patients had sexual dysfunction – the most common type being dysfunction in achieving orgasm (74.5%), followed by unsatised sexual pleasure (66%), difculty in sexual arousal (53.2%), and erectile dysfunction (46.8%). Sexual dysfunction was found to be signicantly associated with the duration of alcohol dependence, amount of alcohol consumed per day, and severity of alcohol dependence. Conclusions: The study highlights the detrimental effects of alcohol on sexual function that we can use in motivational interviewing of patients with alcohol dependence syndrome.

Development of the motivational thought frequency scale for alcohol abstinence (MTF-A).

For most treatment-seeking patients with severe Alcohol Use Disorder (AUD), abstinence is the clinically indicated goal. Existing AUD motivation scales are non-specific about treatment consumption goals, which limit their effectiveness. Desires and mental imagery are relevant in the motivation for AUD treatment engagement. The Motivational Thought Frequency Scale for an abstinence goal (MTF-A) was adapted from the MTF for controlled drinking (MTF-CD). This study psychometrically evaluated the MTF-A in an alcohol-dependent sample engaged in treatment with a goal of abstinence. To enhance the clinical utility of the scale, a secondary aim was to evaluate a psychometrically equivalent short version of the MTF-A. A sample N of 329 treatment-seeking patients with AUD (mean age of 44.44 years, SD=11.89 years, 72% male) who were undertaking a cognitive behavioral treatment (CBT) program for abstinence completed the Motivational Thought Frequency Scale for Abstinence (MTF-A) and the Severity of Alcohol Dependence Questionnaire (SADQ). The MTF-A measured motivation for abstinence through four factors: intensity, self-efficacy imagery, incentives imagery, and availability. Confirmatory factor analyses (CFAs) were conducted to examine factor structure and model fit. Cronbach's alpha assessed internal consistency. Predictive validity was determined by logistic regression predicting first-session treatment non-attendance and alcohol consumption between baseline assessment andcommencement of treatment, controlling for potential confounds. A four-factor structure provided the best fit for the MTF-A, compared with one- and three-factor models. A shortened 9-item MTF-A scale (S-MTF-A) provided better fit than the 13-item MTF-A scale. Both MTF-A and S-MTF-A displayed good internal consistency. Although both MTF-A and S-MTF-A successfully predicted first-session treatment non-attendance, neither predicted alcohol consumption between the baseline assessment and commencement of treatment. The model fit of the four-factor, 9-item S-MTF-A was superior to the original 13-item MTF-A. Both scales were predictive of participation of AUD treatment. Desires and mental imagery play an important role in AUD treatment motivation.

Effectiveness of dynamic homoeopathic preparation of Nux vomica in reducing the craving for alcohol in dependent subjects

Background: Alcohol is one of the main contributors to diseases world-wide which leads to a potentially preventable death. Alcohol use disorders are the most prevalent of all substance use disorders. Alcohol dependence poses physical, psychological, economic and social issues to the individual, families and community. Objectives: To assess the effectiveness of Nux Vomica 1M in reducing the craving for alcohol in dependent subjects.Materials and Methods: Cases presenting with Alcohol dependence are assessed with Penn Alcohol Craving Scale (PACS) and Severity of Alcohol Dependence Questionnaire (SADQ) for craving and dependence respectively. Nux vomica 1M was given orally twice a day for 8 weeks. The data obtained from the pre and post treatment was statistically analyzed. Results: Paired sample t test showed that there is a statistically significant difference between the before and after PACS scores (t=9.55, df=29, p< 0.001) with a mean difference of 7.77±0.81(95%CI: 6.10to 9.43). The before and after scores of SADQ were significantly different (t=8.94, df=29, p