Severity Of Alcohol Dependence Research Articles

DEPRESSION IN FAMILY MEMBERS OF ALCOHOL DEPENDENCE PATIENTS: AN OBSERVATIONAL STUDY

Objectives: The aim of the study was to find out prevalence and severity of depression in family members of alcohol-dependence patients. Methods: This was a cross-sectional, observational study in which 50 family members of patients with alcohol dependence according to mental and behavioral disorders diagnostic criterion for research (ICD-10 DCR) included on the basis of a predefined inclusion and exclusion criteria. The severity of alcohol dependence was assessed by Alcohol Use Disorders Identification Test-C (AUDIT-C) score. The incidence of depression and its severity in family members was assessed by Hamilton Rating Scale for Depression (HAM-D) score. The correlation of AUDIT-C score in alcohol-dependent patients and HAM-D score in family members was done by using Pearson coefficient correlation statistical purposes p<0.05 was considered as statistically significant. Results: Out of the 50 patients with alcohol dependence, 48 (96.00%) were males and 2 (4%) were females. The mean age of the patients was found to be 41.12±11.02. The mean duration of alcoholism was 8.16±5.39 years. 19 (38%) patients had AUDIT-C score of 8 whereas AUDIT-C score of 10 and 12 was found in 16 (32%) and 15 (30%) patients each. The most commonly affected relative was spouse (40%), followed by mother (26%), brother (20%), and father (14%). Majority of the family members (82%) had mild depression (score between 8 and 13). Nine (18%) patients did not have any depression. Moderate, severe, or very severe depression was not seen in any family member. There was a significant positive correlation between AUDIT-C score in alcohol-dependent patients and HAM-D score in family members (R score=0.6333 and p<0.005). Conclusion: There is a significant psychological impact, particularly depression, of alcohol dependence on family members. Severity of hazardous drinking correlated positively with the incidence of depression in family members.

Factors that can influence neurocognitive performance: a case study in a controlled environment

ABSTRACT This is a case study of a patient in her 50s who presents with severe malnutrition, alcohol dependence, and untreated Bipolar Affective Disorder. She was hospitalized multiple times and placed in a group home 1 year after symptom onset. Cognitive and functional improvements are observed over a 6-year period, as demonstrated by 3 comprehensive neuropsychological evaluations. Residing in a monitored and structured environment for 6 years, with stability in psychiatric medications, monitored nutrition and abstinence from alcohol are attributed to this improvement. This study provides unique evidence of the impact of balanced nutrition and improvements in psychiatric symptoms on cognition.

Combustible cigarette smokers versus e-cigarette dual users among Latinx individuals: Differences in alcohol and drug use severity.

The Latinx population in the United States (U.S.) experiences significant tobacco and other substance use-related health disparities. Yet, little is known about the couse of combustible cigarettes and e-cigarettes (dual use) in relation to substance use behavior among Latinx smokers. The present investigation compared English-speaking Latinx adults living in the United States who exclusively smoke combustible cigarettes versus dual users in terms of alcohol use and other drug use problem severity. Participants were 297 Hispanic/Latinx daily cigarette smokers (36.4% female, Mage = 35.9 years, SD = 8.87) recruited nationally across the United States using Qualtrics Panels to complete self-report measures of behavioral health outcomes. Five analysis of covariance models were conducted to evaluate differences in overall alcohol consumption, dependence, related problems, hazardous drinking, and drug use problem severity between exclusive combustible cigarette smokers (N = 205) and dual users (N = 92). Results indicated that dual users evinced greater levels of alcohol consumption, dependence, alcohol-related problems, and hazardous drinking compared to exclusive combustible cigarette smokers (ps < .001). Dual users also reported greater levels of drug use problems relative to exclusive combustible cigarette smokers (p < .001). The current findings are among the first to document that dual cigarette and e-cigarette use status (compared to exclusive combustible cigarette smoking) may serve as a clinically relevant risk indicator for a range of deleterious substance use problems among Latinx individuals. Future research is needed to corroborate these findings and examine dual-use status as a longitudinal predictor of alcohol and other substance-related problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PSYCHIATRIC MORBIDITY AND MARITAL SATISFACTION IN SPOUSES OF PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME

Background: Prevalence of alcohol dependence in men has been increasing worldwide, particularly in India. Alcohol dependence syndrome appears to be associated with psychiatric problems specially among spouses. Understanding and addressing the effects of such psychiatric problems becomes necessary. Aim: The aim of this study was to assess the pattern of psychiatric morbidity and marital satisfaction in spouses of patients with alcohol dependence syndrome. Materials and Methods: 246 men with alcohol dependence syndrome and their spouses were evaluated. Marital satisfaction was assessed using the ENRICH marital satisfaction scale. Mini International Neuropsychiatric Interviews (MINI) was used to screen for the possible presence of psychiatric morbidity among spouses. Severity of alcohol dependence in the husbands and consequences of drinking was assessed using Short Alcohol Dependence Data (SADD) and drinkers inventory of consequences (DrInC) respectively. Results: More than half of the spouses (57.72%) had a psychiatric disorder. Primarily mood and anxiety disorder were present. Major depressive disorder was present in 33.33%. Psychiatric morbidity among spouses was significantly associated with SADD. Significant association was found between age, education status, occupation, religion and psychiatric morbidity of spouses. Marital satisfaction score was low and conflicts between the couple was significantly associated with psychiatric morbidity of spouses. Conclusion: Psychiatric morbidity in spouses of alcohol dependent men is high, with marital satisfaction being low. Addressing these issues in spouses can improve their quality of life as they play an important role in the treatment of alcohol dependence syndrome.

Pain Intensity, Pain-Related Anxiety, and Hazardous Drinking Among Individuals With PTSD

Objective Evidence suggests that pain intensity may be indirectly linked to hazardous drinking and PTSD symptom severity via pain-related anxiety. The goal of this analysis was to test the hypotheses in a population with PTSD symptoms that pain intensity would be positively and indirectly associated with hazardous drinking, alcohol dependence, alcohol-related problems, and PTSD symptom severity via pain-related anxiety. Methods Heavy drinkers with probable PTSD were recruited via Qualtrics panels (N = 371, 53% Female, M age = 39.68, SD = 10.86). Linear regression and conditional process models were conducted to examine indirect associations between pain intensity and primary outcomes via pain-related anxiety. Results Pain intensity was found to be indirectly associated with hazardous drinking, alcohol dependence, alcohol-related problems, and PTSD symptom severity via greater pain-related anxiety. Conclusion These initial findings suggest that pain-related anxiety may play an important role in relations between the experience of pain and hazardous patterns of alcohol consumption among individuals with probable PTSD. Future research is needed to determine the temporal nature of these associations and to examine the potential utility of treatments that address pain-related anxiety in the context of comorbid pain, PTSD, and hazardous drinking.

A voxel-level resting-state fMRI study on patients with alcohol use disorders based on a power spectrum slope analysis method.

Earlier neuroimaging investigations showed that abnormal brain activity in patients with alcohol use disorder (AUD) was frequency dependent. However, there is lacking of a comprehensive method to capture the amplitude of multi-frequency bands directly. Here, we used a new method, the power spectrum slope (PSS) to explore abnormal spontaneous activity of brain in patients with AUD. Thirty-three AUD patients and 29 healthy controls (HCs) enrolled in this study. The coefficient b and the power-law slope b' were calculated and compared between two groups. We also used the receiver operating characteristic (ROC) curve to examine the ability of the PSS analysis to distinguish between AUD and HCs. We next examined the correlation between PSS difference in the brain areas and the severity of alcohol dependence. Thirty AUD patients and 26 HCs were retained after head motion correction. The two metrics of PSS values increased in the left precentral gyrus in AUD patients. The area under the curve values of PSS differences in the specific brain area were respectively 0.836 and 0.844, with sensitivities of 86.7% and 83.3% and specificities of 73.1% and 76.9%. The Michigan Alcoholism Screening Test (MAST) and Alcohol drinking scale (ADS) scores were not significantly correlated with the PSS values in the specific brain area. As a novel method, the PSS can well detect abnormal local brain activity in the AUD patients and may offer new insights for future fMRI studies.

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.

Mental Imagery to Reduce Alcohol-related harm in patients with alcohol use disorder and alcohol-related liver damaGE: the MIRAGE randomised pilot trial results

ObjectiveThe healthcare burden of alcohol-related liver disease (ARLD) is increasing. ARLD and alcohol use disorder (AUD) is best managed by reduction or cessation of alcohol use, but effective treatments are...

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.

Frequency of high risk behaviour in patients with alcohol dependence syndrome: a cross sectional study

Background: Alcohol use and high-risk behaviour has been shown to have an association. Severity of alcohol dependence has an association with frequency of risk-taking behaviour. Objectives were to evaluate the frequency of high risk behaviour in alcohol dependence syndrome and to find any correlation between psychosocial variables and high risk behaviour. Methods: 100 individuals with ICD 10 diagnosis of alcohol dependence syndrome were studied using semi structured interview. High risk behaviour was assessed using violent risk appraisal guide and deliberate self-harm inventory. The age of onset of initiation of alcohol use and dependence and severity of alcohol dependence syndrome were assessed and analyzed by frequency and Chi square test. Results: In 100 subjects with alcohol dependence syndrome, 4 (17.4%) and 7 (30.4%) of subjects with severe dependence had road traffic accidents and risky sexual and violent behaviour respectively. There was a statistically significant association between age of onset, age of dependence and high-risk behaviour. Conclusions: The present study concluded that most individuals with alcohol dependence syndrome had high risk behaviour. Road traffic accident was the most common followed by risky sexual and violent behaviour. There was a significant association between severity of alcohol dependence and high risk behaviour.

Habit-, reward- and fear-related motivations in alcohol use disorder: A one-year prospective study

ObjectiveCross-sectional studies show that habitual use of alcohol is associated with severity of alcohol dependence reflected across a range of domains and lower number of detoxifications in multiple settings. In this study, we investigated whether alcohol use disorder (AUD) patients with greater habitual use of alcohol at baseline showed worse outcomes after one year of follow-up. MethodsA sample of inpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorder (AUD) was assessed at baseline (n = 50) and after one year (n = 30). The Habit, Reward, and Fear Scale (HRFS) was employed to quantify affective (fear or reward) and non-affective (habitual) drives for alcohol use, the Alcohol Dependence Scale (ADS) was used to assess clinical outcomes, and the Depression, Anxiety and Stress Scale (DASS-21) was used to quantify and control for associated affective symptoms. ResultsThere was a significant reduction in the three HRFS scores at the follow-up. Regression analyses demonstrated that greater habit- and fear-related drives at baseline predicted greater decreases in the ADS scores at the endpoint. However, after controlling for age, sex and affective symptoms, only reward and fear were associated with reductions in ADS scores at the end of one year. Prescriptions of naltrexone and antidepressants/benzodiazepines did not predict decreases in reward and fear-related motivations. ConclusionAlthough we were unable to confirm that habitual subscores at baseline predict worse long-term outcomes among inpatients with AUD, we found that a greater fear and reward motives for the use of alcohol predicted a greater magnitude of improvement in the AUD symptoms after one year. We hope that these findings will help develop new approaches toward AUD treatment and inform models of addiction research.

Psychological hardiness, personality factors and coping styles in male patients of alcohol dependence syndrome

BackgroundAlcohol dependence syndrome (ADS) is a result of complex interplay between biological, psychological, and sociocultural factors. While the biological (genetic) factors remain non-modifiable, better understanding of individual hardiness, personality variables, and coping mechanisms can help us in better understanding and comprehensive management of the illness. MethodsA cross-sectional comparative study was conducted at a tertiary care hospital. A total of 112 patients with ADS (test group) and 124 healthy age matched male controls were recruited from the same social milieu. They were assessed for hardiness, personality factors, and coping mechanisms using Hardiness scale, 16 Personality factors (5th Edition), and Brief COPE scale, respectively. The data were analyzed with Chi square, Student t tests (two tailed, unpaired), Mann Whitney U test, and Kruskal Waal analysis. ResultsThe test group had less hardy personality compared to control group (25% vs 43.54%) (p = 0.002). The level of Hardiness had an inverse relationship with alcohol dependence (p = 0.886). The majority of patients with ADS had high score on extraversion (p < 0.001), anxiety (p < 0.001), and tough-mindedness (p < 0.001), and the severity of alcohol dependence had an inverse relationship with extraversion (p = 0.004) and self-control (p = 0.002). The severity of ADS was directly related to the use of emotional support (p = 0.007) and substance use (p = 0.005) as coping mechanisms while the use of instrumental support (p = 0.001) and humor (p < 0.001) had inverse relationship with the severity of ADS. ConclusionsADS had less hardy personality and the level of hardiness had inverse relationship with alcohol dependence. The severity of alcohol dependence had an inverse relationship with extraversion and self-control. In terms of coping styles, substance use and use of emotional support was found to be directly related with the severity of alcohol dependence while the use of instrumental support and humor were found to be protective against severe dependence.

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

ABSTRACT Background: 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. Our study aimed to assess the prevalence and severity of alcohol dependence among patients with Alcoholic Liver Disease (ALD). Methods: 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. Results: 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 &gt;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. Conclusions: 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.

0305 Use of Sleep Medication Increases with Greater Severity of Hazardous Alcohol Use

Abstract Introduction Hazardous alcohol use correlates with greater insomnia, potentially leading to increased use of sleep medications. However, combining sleep medications with alcohol can yield serious and even fatal health consequences. We examined the relationship between alcohol use and sleep medication use during the first year of the COVID-19 pandemic and hypothesized that greater alcohol use would correlate with increased use of sleep medication. Methods N=3,930 English-speaking adults from across the U.S. (Mage=37.2, SD=12.4) completed the Pittsburgh Sleep Quality Index (PSQI) and the Alcohol Use Disorders Identification Test (AUDIT) at one of four timepoints (April, July, and October of 2020 and in January of 2021). Individual use of sleep aids was measured by ranking them from 0 (none) to 2 (once or twice a week or more). Additionally, alcohol use was ranked from 0-3 where a higher score indicated higher alcohol dependence. Results Alcohol use was modestly but positively correlated with sleep medication use (r = 0.183, p&amp;lt; 0.001). A chi-square analysis showed that the proportion of people reporting heavy use of sleep medications increased among those reporting greater severity of hazardous alcohol use (p&amp;lt; 0.001). Specifically, 21.8% of those in the non-hazardous drinking category reported heavy use of sleep medications, while 25.3% of those in the hazardous drinking group described heavy sleep medication use. For those meeting criteria for probable alcohol dependence, 39.7% reported heavy sleep medication use, and 57.3% meeting criteria for severe alcohol dependence reported heavy sleep medication use. Conclusion We found that individuals who scored higher on alcohol use scored higher on sleep medication use, consistent with our hypothesis. These results show that during the COVID-19 pandemic, hazardous alcohol use and sleep medication use were significantly associated. Such findings are concerning, because when combined, alcohol and sleep medications can lead to serious health consequences, including impaired neurocognitive functioning, sleep disruption, parasomnias, risk of overdose, and even death. Given the potential severe risks associated with this behavior, increased clinical assessment, monitoring, and counseling about the dangers of mixing sleep medication with alcohol is warranted. Further work should identify the causal direction and potential mediating factors driving these associations. Support (if any)

Characteristics of amplitude of low-frequency fluctuations in the resting-state functional magnetic resonance imaging of alcohol-dependent patients with depression.

The high comorbidity of alcohol use disorder and depressive disorder is associated with poor patient prognosis. The mechanisms underlying this comorbidity, however, are largely unknown. By applying the amplitude of low-frequency fluctuations parameter in resting-state functional magnetic resonance imaging, this study investigated changes in the brain functioning of alcohol-dependent patients with and without depression. Alcohol-dependent patients (n = 48) and healthy controls (n = 31) were recruited. The alcohol-dependent patients were divided into those with and without depression, according to Patients Health Questionnaire-9 scores. Amplitude of low-frequency fluctuations in resting-state brain images were compared among the alcohol-dependent patients with depression, alcohol-dependent patients without depression, and healthy controls groups. We further examined associations between amplitude of low-frequency fluctuations alterations, alcohol-dependence severity, and depressive levels (assessed with scales). Compared with the healthy controls group, both alcohol groups showed amplitude of low-frequency fluctuations enhancement in the right cerebellum and amplitude of low-frequency fluctuations abatement in the posterior central gyrus. The alcohol-dependent patients with depression group had higher amplitude of low-frequency fluctuations in the right cerebellum than the alcohol-dependent patients without depression group. Additionally, we observed a positive correlation between amplitude of low-frequency fluctuations value and Patients Health Questionnaire-9 score in the right superior temporal gyrus in the alcohol-dependent patients with depression group. Alcohol-dependent subjects showed abnormally increased spontaneous neural activity in the right cerebellum, which was more significant in alcohol-dependent patients with depression. These findings may support a targeted intervention in this brain location for alcohol and depressive disorder comorbidity.

Case-only exome variation analysis of severe alcohol dependence using a multivariate hierarchical gene clustering approach.

Variation in genes involved in ethanol metabolism has been shown to influence risk for alcohol dependence (AD) including protective loss of function alleles in ethanol metabolizing genes. We therefore hypothesized that people with severe AD would exhibit different patterns of rare functional variation in genes with strong prior evidence for influencing ethanol metabolism and response when compared to genes not meeting these criteria. Leverage a novel case only design and Whole Exome Sequencing (WES) of severe AD cases from the island of Ireland to quantify differences in functional variation between genes associated with ethanol metabolism and/or response and their matched control genes. First, three sets of ethanol related genes were identified including those a) involved in alcohol metabolism in humans b) showing altered expression in mouse brain after alcohol exposure, and altering ethanol behavioral responses in invertebrate models. These genes of interest (GOI) sets were matched to control gene sets using multivariate hierarchical clustering of gene-level summary features from gnomAD. Using WES data from 190 individuals with severe AD, GOI were compared to matched control genes using logistic regression to detect aggregate differences in abundance of loss of function, missense, and synonymous variants, respectively. Three non-independent sets of 10, 117, and 359 genes were queried against control gene sets of 139, 1522, and 3360 matched genes, respectively. Significant differences were not detected in the number of functional variants in the primary set of ethanol-metabolizing genes. In both the mouse expression and invertebrate sets, we observed an increased number of synonymous variants in GOI over matched control genes. Post-hoc simulations showed the estimated effects sizes observed are unlikely to be under-estimated. The proposed method demonstrates a computationally viable and statistically appropriate approach for genetic analysis of case-only data for hypothesized gene sets supported by empirical evidence.

Maternal choline supplementation during pregnancy to promote mental health in offspring.

There is increasing interest in the role of choline in brain development, including its possible role in promoting mental health and preventing mental illness. Choline is an essential micronutrient in fetal brain maturation. In more than 90% of pregnant women, choline intake has been found to be lower than the daily-recommended dose. The aim of this article is to review what is known about the effects of maternal choline supplementation on fetal brain development, early child development and mental health. A narrative review of the literature. A limited number of studies suggest that maternal choline supplementation during pregnancy may enhance fetal brain development and improve early signs and symptoms that may predispose to mental illness. The general low maternal choline intake during pregnancy, expected health benefits and low risks, make a plea for maternal choline supplementation to promote mental health. Choline supplementation may be especially important for pregnant women with a (family) history of severe mental illness and/or alcohol dependence.

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.