Short Alcohol Dependence Data Research Articles

Assessing alcohol dependence in hospitalized patients.

Alcohol misuse is generally not detected in hospital settings. The goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in Sao Paulo (Brazil). Patients were randomly selected from all hospital admissions. The final sample consisted of 169 adult inpatients. Two screening tools were used: the Short Alcohol Dependence Data (SADD) and the CAGE questionnaires. In this sample, 25.4% of patients could be considered alcohol dependent according to the CAGE questionnaire, whereas 32.9% of patients fulfilled the criteria according to the SADD. The only predictor of alcohol dependence was gender; male inpatients were 3.2 times more prone to alcohol dependence with female inpatients. All inpatients should be systematically screened for alcohol use disorders. The choice of the screening tool will depend on whether the goal is to identify inpatients with hazardous drinking behaviors or with established alcohol-related problems. To maximize proper case identification, the CAGE questionnaire should be used as a first-step screening tool, and patients who screen positive on this scale should be subsequently administered the SADD questionnaire to assess the severity of the condition.

Yoga as an adjunct treatment for alcohol dependence: A pilot study

This pilot study explores the feasibility of yoga as part of a treatment program for alcohol dependence. Eighteen alcohol dependent patients were randomized to receive either treatment as usual or treatment as usual plus yoga. Assessments were taken at baseline and six month follow-up. 'Riddargatan 1': an outpatient alcohol treatment clinic located in Stockholm, Sweden. Treatment as usual consisted of psychological and pharmacological interventions for alcohol dependence. The 10-week yoga intervention included a weekly group yoga session. Participants were encouraged to practice the yoga movements at home once per day. Alcohol consumption (timeline follow-back method, DSM-IV criteria for alcohol dependence, and the Short Alcohol Dependence Data questionnaire), affective symptoms (the Hospital Anxiety and Depression Scale), quality of life (Sheehan Disability Scale) and stress (the Perceived Stress Scale and saliva cortisol). Yoga was found to be a feasible and well accepted adjunct treatment for alcohol dependence. Alcohol consumption reduced more in the treatment as usual plus yoga group (from 6.32 to 3.36 drinks per day) compared to the treatment as usual only group (from 3.42 to 3.08 drinks per day). The difference was, however, not statistically significant (p = 0.17). Larger studies are needed to adequately assess the efficacy and long-term effectiveness of yoga as an adjunct treatment for alcohol dependence.

Association between socio-demographics and alcohol dependence among individuals living in an Indian setting.

Background:Alcohol use is on the rise worldwide and urgent steps are required to curb this growing burden of alcohol consumption. Alcohol drinking leads to serious social, physical and mental consequences.Objective:The objective of this pilot study is to examine association between socio-demographics and severity of alcohol dependence among individuals obtaining treatment at alcohol de-addiction center.Methods:This pilot cross sectional study was conducted in September 2013 in South India. A convenient sample of 100 participants was enrolled. Individuals aged 30 years and above, receiving treatment from de-addiction center and providing written informed consent were eligible for the study. A modified version of previously validated questionnaires was used for gathering information on socio-demographic characteristics, severity of alcohol dependence (using Alcohol Dependent Scale [ADS] and Short Alcohol Dependence Data questionnaire [SADD]), motivational incentives for alcohol quitting and challenges faced while quitting alcohol.Results:All participants were males with mean age of 43 years (SD = 6.5 years). Significant association was seen between ADS and annual income (p = 0.001), education (p = 0.001), occupation (p < 0.0001) and work timing (p < 0.0001). Similar results were seen with SADD scores. Family support (100%) and health (60%) were reported to be the most important motivating factors for quitting alcohol.Discussion:Results showed an urgent need of interventions that are family centered and focus on unskilled, less educated individuals having high work stress. Public health interventions should not only be home based, but should also include worksite awareness initiatives. A national policy is needed to promote alcohol quitting and to bring awareness regarding the consequences of alcohol consumption on individual’s life.

Fatores de risco cardiovascular em alcoolistas em tratamento

OBJETIVO: Avaliar a presença de fatores de risco cardiovascular, com ênfase na hipertensão e na adiposidade corporal, em alcoolistas abstinentes ou não abstinentes em tratamento. MÉTODO: Trata-se de um estudo transversal com 65 pacientes alcoolistas em tratamento no CAP-Sad. O grau de dependência do álcool foi avaliado pelo SADD (Short Alcohol Dependence Data) e o uso de outras drogas, pelo ASSIST (Alcohol Smoking and Substance Involvement Screening Test). Foram avaliados o perfil bioquímico e o antropométrico dos usuários. RESULTADOS: Participaram do estudo 42 homens e 23 mulheres. A maioria dos participantes (67,74%) apresentou dependência alcoólica grave, com uso de álcool associado principalmente a cigarro (66,15%). A média da circunferência da cintura (CC) foi significativamente maior entre os abstinentes, em comparação aos não abstinentes (AB: 88,15 ± 15,95 x NA: 81,04 ± 9,86; p = 0,03). Pacientes abstinentes há mais tempo tiveram maior sobrepeso/obesidade e adiposidade abdominal (CC) do que os não abstinentes e abstinentes recentes, com razão de chances de 5,25. Os abstinentes apresentaram razão de chances de 3,38 para %GC acima da média, independente do tempo de abstinência. CONCLUSÃO: Pacientes alcoolistas abstinentes apresentam mais sobrepeso/ obesidade, adiposidade corporal (%GC) e abdominal (CC) do que os não abstinentes. É importante o acompanhamento multiprofissional no tratamento de alcoolistas com abordagem para fatores de risco cardiovasculares, principalmente evitando o ganho de peso.

Abstinence after First Acute Alcohol-Associated Pancreatitis Protects Against Recurrent Pancreatitis and Minimizes the Risk of Pancreatic Dysfunction

To determine the recurrence of pancreatitis and subsequent pancreatic function in patients who stop drinking after the first episode of alcohol-associated pancreatitis. Of a total of 118 patients suffering from their first alcohol-associated pancreatitis, 18 (all men, age median 47 (27-71) years) met the inclusion criterion for abstinence during follow-up. The criterion for abstinence was alcohol consumption <24 g per 2 months (self-estimated), which is in line with questionnaires eliciting alcohol consumption and dependency (Alcohol Use Disorders Identification Test < 8 and Short Alcohol Dependence Data < 9). Recurrent attacks of acute pancreatitis were studied. Smoking, body mass index and laboratory tests detecting heavy consumption of alcohol were recorded. Blood and faecal tests were studied to assess endocrine and exocrine pancreatic function. During a mean follow-up time of 5.15 (1.83-9.13) years and a total of 92.7 patient-years, there were no recurrent attacks of acute pancreatitis among the 18 abstainers. Two patients had diabetes prior to and one was diagnosed immediately after the first episode of acute pancreatitis. One patient had impaired glucose metabolism at 2 years. Two patients had low insulin secretion in glucagon-C-peptide test, one at 4 years and the other at 5 years. Only one patient (6%) maintained low elastase-1 activity during the abstinence follow-up. Of the 100 non-abstainers, 34% had at least one recurrence during the follow-up. Regardless of the mediator mechanisms of acute alcoholic pancreatitis, abstinence after the first episode protects against recurrent attacks. Pancreatic dysfunction is also rare among abstinent patients.

Psychiatric morbidity and marital satisfaction among spouses of men with alcohol dependence

Background:Alcohol dependence has adverse health and social consequences; Alcohol related problems primarily occur within the family context and maximum impact is felt on spouses, given the intimate nature of their relationship. Spouses play an important role in treatment programs related to alcohol. There is thus a need to study psychiatric morbidity and marital satisfaction in spouses of alcohol dependent patients in order to understand and address such issues.Aims:The aim of this study was to assess the pattern of psychiatric morbidity, marital satisfaction in spouses of men with alcohol dependence syndrome and explore the association.Materials and Methods:For psychiatric morbidity, 60 spouses of men with alcohol dependence syndrome were evaluated. Marital satisfaction was assessed using the marital satisfaction scale. Severity of alcohol dependence in the husbands and consequences of drinking was assessed using short alcohol dependence data and drinkers inventory of consequences respectively.Results:More than half of the spouses (65%) had a psychiatric disorder. Primarily mood and anxiety disorder were present. Major depressive disorder was present in 43%. Psychiatric morbidity, marital dissatisfaction in spouses and higher adverse consequences alcohol dependence in their husbands, were found to be significantly correlated with each other and their association was robust particularly when problems in the physical, interpersonal and intrapersonal domains were high.Conclusion:Psychological distress and psychiatric morbidity in spouses of alcohol dependent men is high, with marital satisfaction being low. Addressing these issues will be beneficial as spouses are known to play an important role in the treatment of alcohol dependence syndrome.

Female sexual dysfunction in patients with substance-related disorders

OBJECTIVE:To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit.METHODS:This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerström Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered.RESULTS:The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerström Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence.CONCLUSIONS:Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use.

The surgical resectability following neoadjuvant therapy in pancreatic head cancer

s / Pancreatology 526 Objectives. Alcohol is a risk factor for acute pancreatitis. In our previous two year follow up abstinence protected for recurrences. Our aim was to further determine recurrence of pancreatitis and later pancreatic function in patients who quit drinking after the first episode of alcoholassociated pancreatitis. Materials andmethods: Out of the total of 120 patients with their first alcohol-associated pancreatitis, 23 (20 M, 3 F; age median 47 (27–60) years) met the inclusion criteria for abstinence during the follow up. The criteria for abstinence were alcohol consumption less than 24 grams per twomonths (self-estimated) which is in line with questionnaires detecting alcohol consumption and dependency (Alcohol Use Disorders Identification Test, AUDIT < 8 and Short Alcohol Dependence Data, SADD < 9). Recurrent attacks of acute pancreatitis were studied. Smoking, body-mass index and laboratory tests detecting heavy use of alcohol were recorded. Blood and fecal tests were studied to assess endocrine and exocrine pancreatic function. Results: During a mean follow up time of 4.8 (2–9) years and total of 111 patient years therewere no recurrent attacks of acute pancreatitis. Two patients had diabetes prior to and two just after the first episode of acute pancreatitis. One patient demonstrated new onset diabetes during the follow up at 1.5 years. One patient showed low elastase activity at 2 and another at 3 years, but no-one later on. Conclusions: Abstinence after the first acute alcohol-associated pancreatitis protects from recurrent attacks and seems to decrease the risk for pancreatic dysfunction.

The significance of endo-ultrasonography in the preoperative management of patients with (early) pancreatic cancer

s / Pancreatology 526 Objectives. Alcohol is a risk factor for acute pancreatitis. In our previous two year follow up abstinence protected for recurrences. Our aim was to further determine recurrence of pancreatitis and later pancreatic function in patients who quit drinking after the first episode of alcoholassociated pancreatitis. Materials andmethods: Out of the total of 120 patients with their first alcohol-associated pancreatitis, 23 (20 M, 3 F; age median 47 (27–60) years) met the inclusion criteria for abstinence during the follow up. The criteria for abstinence were alcohol consumption less than 24 grams per twomonths (self-estimated) which is in line with questionnaires detecting alcohol consumption and dependency (Alcohol Use Disorders Identification Test, AUDIT < 8 and Short Alcohol Dependence Data, SADD < 9). Recurrent attacks of acute pancreatitis were studied. Smoking, body-mass index and laboratory tests detecting heavy use of alcohol were recorded. Blood and fecal tests were studied to assess endocrine and exocrine pancreatic function. Results: During a mean follow up time of 4.8 (2–9) years and total of 111 patient years therewere no recurrent attacks of acute pancreatitis. Two patients had diabetes prior to and two just after the first episode of acute pancreatitis. One patient demonstrated new onset diabetes during the follow up at 1.5 years. One patient showed low elastase activity at 2 and another at 3 years, but no-one later on. Conclusions: Abstinence after the first acute alcohol-associated pancreatitis protects from recurrent attacks and seems to decrease the risk for pancreatic dysfunction.

Reliability and dimensionality of the Short Alcohol Dependence Data (SADD) questionnaire in a clinical sample of hospitalized patients: using the SADD in a general hospital setting

To assess the internal consistency and dimensionality of the Short Alcohol Dependence Data questionnaire in a general hospital sample. A cross-sectional study was carried out involving 169 randomly selected inpatients of a general hospital in São Paulo, Brazil. A Portuguese version of the 15-item Short Alcohol Dependence Data questionnaire was applied together with a questionnaire to assess demographic and anthropometric data. The internal consistency of the Short Alcohol Dependence Data as measured using Cronbach's alpha was 0.79, indicating that the items of the questionnaire are related to the same construct. Principal Component Analysis of the scale resulted in a five-dimension solution accounting for 69.6% of the total variance. The mean score of the Short Alcohol Dependence Data in this sample was 7.96 (SD = 6.8). The adapted version of the SADD seems to retain the characteristics of the original version. The internal consistency of the instrument suggests that its questions converge to the same construct. The factorial solution reflects different dimensions that correspond to distinct aspects of the alcohol dependence syndrome.

Risk factors for recurrent acute alcohol-associated pancreatitis: A prospective analysis

Objective. In an earlier retrospective study we showed that 46% of patients with acute alcoholic pancreatitis had recurrent attacks within 10–20 years, about 30% having a recurrence during the first 3 years. The aim of this prospective follow-up study was to determine the risk factors associated with recurrences. Material and methods. Sixty-eight patients, (59 M, 9 F, mean age 46 years, range 25–71 years) who survived their first acute alcohol-induced pancreatitis from January 2001 to January 2004 volunteered to participate in the study. The diagnostic criteria for acute pancreatitis were epigastric pain, serum amylase >3 times the upper normal range, elevated serum C-reactive protein (CRP), and signs of acute pancreatitis in imaging. Other etiologies were excluded. Alcohol consumption and dependency were detected by the Alcohol Use Disorders Identification Test (AUDIT) and the Short Alcohol Dependence Data (SADD), respectively, and by attempting to evaluate recent use in grams of pure alcohol. Social and demographic data of the patients, smoking, body mass index, and the severity of the pancreatitis were recorded. Serum and fecal markers of the endocrine and exocrine function and secretin-stimulated MRCP were studied. The patients were followed for a median 38 (25–61) months for recurrences, and at the 2-year time-point had a follow-up visit to investigate any changes in alcohol consumption. Results. Seventeen (25%) patients had recurrences of acute alcoholic pancreatitis during the follow-up. Pre-illness alcohol consumption, the severity of the pancreatitis, patient's social or demographic data, pancreatic function tests or morphologic changes in MRCP, or smoking did not correlate with recurrence. None of the 13 patients with consistent total abstinence from alcohol at 2 years developed recurrent pancreatitis compared with 17 out of 51 (33%) patients with at least some alcohol consumption (p=0.02). Use of other sedatives than alcohol before the first attack of pancreatitis was an independent risk factor associated with recurrence (HR = 6.95, 95% CI 2.45–19.72, p<0.001). A lower reduction in dependency on alcohol (less decreased SADD points) during 2 years was associated with a higher recurrence rate (HR = 0.921/each reduced point, 95% CI 0.872–0.974, p=0.004). Conclusions. Contrary to chronic pancreatitis, smoking was not found to be a risk factor for recurrent episodes after the first attack of acute alcoholic pancreatitis. Abstinence from alcohol protects against recurrent pancreatitis. Patients who developed recurrent acute pancreatitis had increased dependency on alcohol, demonstrated by the use of other sedatives in addition to alcohol and supported by the less decreased dependency during the follow-up.

Comparing serial and nonserial sexual offenders: alcohol and street drug consumption, impulsiveness and history of sexual abuse

To evaluate the differences between serial and nonserial sexual offenders in terms of alcohol and drug consumption, impulsivity, and personal history of being sexually abused. A sectional and retrospective study carried out by the team of the outpatient clinic for the treatment of sexual disorders at Faculdade de Medicina do ABC - Santo André, Brazil. Three groups of subjects (n = 198) consisting of sexual offenders against one victim, two victims and three or more victims were examined. Convicts sentenced only for sexual crimes were evaluated with the Drug Addiction Screening Test, the CAGE, the Short Alcohol Dependence Data, the Barratt Impulsiveness Scale, the Sexual Addiction Screening Test, and the Static-99. Sexual offenders against three or more victims showed more frequent history of being sexually abused than the sexual offenders against one victim. A one-way analysis of variance indicated that sexual offenders against three or more victims evidenced significantly higher scores on the Barratt Impulsiveness Scale and on the Sexual Addiction Screening Test than did the sexual aggressors against one victim. After a multinomial logistic regression analysis, the Barratt Impulsiveness Scale and the history of being sexually abused were predicting factors for the group of aggressors against three or more victims in relation to the aggressors against one victim. Sexual offenders against three or more victims present different characteristics from other groups of sexual offenders and these findings can help to create proposals for the management of this type of inmates.

Freqüência de jogo patológico entre farmacodependentes em tratamento

To investigate the frequency of pathological gambling among alcohol and other substance abusers who sought specialized treatment. Seventy-four outpatients from three different substance abuse treatment services were interviewed. The South Oaks Gambling Screen (SOGS) scale was used for the diagnosis of pathological gambling. The diagnosis of alcohol and other substances abuse was established according to the DSM-IV criteria and the Short Alcohol Dependence Data (SADD) scale. The Portuguese version of the Self-Report Questionnaire (SRQ) scale was used to detect psychiatric symptoms and the Center for Epidemiological Studies Depression Scale (CES-D) for depressive symptoms. Average scores obtained from the application of these scales were compared using the Student t-test. All subjects met the criteria for drug abuse, 61.6% met the alcohol dependence criteria, 60.3% for cocaine/crack, and 34.2% for cannabis. According to the SOGS scale, the majority of drug addicts (70.3%) were classified as social gamblers, 10.8% as problem gamblers and 18.9% as pathological gamblers. Psychiatric and depression symptoms were found in the sample. Pathological gambling patients showed more depression symptoms than non-pathological gambling patients. A high frequency of pathological gambling was found among the drug addicts interviewed. It is emphasized the importance of investigating pathological gambling among patients under treatment of drug abuse and to include strategies for the treatment of this disorder.

The Effectiveness of an Inpatient Group Cognitive Behavioral Therapy Program for Alcohol Dependence

The present study evaluated the effectiveness of attendance at a clinically based, short-term, in-patient group CBT program largely based on Monti, Abrams, Kadden, and Cooney to treat problem drinking. Participants were 37 males and 34 females diagnosed with alcohol dependence. Patients attended 42 CBT sessions over three weeks, with each session being one hour in duration. Measures included the Khavari Alcohol Test (KAT), the Short Alcohol Dependence Data Questionnaire (SADD), the Beck Anxiety Index (BAI), the Symptom Checklist-90-Revised (SCL-90), a General Self-Efficacy scale (GSE), and the Drinking Expectancy Profile (DEP). Group attendance rates were monitored daily. Two structured phone calls were conducted at one month and three months post-discharge. Results showed that attendance rates at CBT group sessions were not associated with improvements found at the end of therapy or in drinking behaviors at three-month follow-up. Full support could not be found for the effectiveness of group CBT and cognitive models of problem drinking.

Psychometric properties of the World Health Organization Quality of Life instrument (WHOQoL-BREF) in alcoholic males: A pilot study

To evaluate criterion convergent and discriminant validity of the World Health Organization Instrument (WHOQoL-BREF) in evaluating quality of life and to verify its convergent validity with the Medical Outcomes study Short-forms (SF-36) and the Symptom Check List (SCL-90) instruments in male alcohol dependent patients who seek treatment at two Brazilian treatment centers. A cross-sectional study was performed, in which cases were divided in to two groups according to the severity of alcohol dependence, ascertained by the Short Form Alcohol Dependence Data scale (SADD). The sample was comprised of 36 males, and 63.9% had severe dependence. Subjects with low/moderate dependence showed higher scores in all domains of the WHOQoL-BREF and in nearly all domains of the SF-36. Criterion validity and internal consistency in the WHOQoL-BREF were satisfactory. With regard to convergent validity between the WHOQoL-BREF and SF-36, most correlation coefficients were significant. The WHOQoL instrument proved to be satisfactory for evaluating quality of life in this sample.

Association Between Psychiatric Symptoms and Severity of Alcohol Dependence in a Sample of Brazilian Men

The objective of this study was to verify the association between psychiatric symptoms and severity of alcohol dependence in male patients who sought treatment in two Brazilian treatment sites. A cross-sectional study was designed with 36 cases stratified into two groups according to the severity of alcohol dependence ascertained by the Short Form Alcohol Dependence Data scale; participants also answered the Mini-Mental State Examination, the Mini International Neuropsychiatric Interview, and the Symptom Check List 90. The mean age of the sample was 46 years, and 63.9% fulfilled criteria for severe alcohol dependence. Obsessive-compulsive, depressive, and paranoid symptoms were the most common clinical findings in the sample. Patients with severe dependence showed higher scores of psychiatric symptoms compared with patients with mild/moderate dependence across all analyses (p < .05). These data suggest an association between severity of alcohol dependence and psychiatric symptoms, pointing at the relevance of early detection of this clinical situation.

Past alcohol problems do not predict worse smoking cessation outcomes

Whether smokers with a past history of alcohol problems are less able to stop smoking and have a greater need for nicotine replacement therapy than smokers without this history is unclear. We conducted a secondary analysis of a prior study (Nicotine Tobacco Res. 1:169) of 1039 smokers randomized to 0, 21, 35 or 42 mg/day nicotine patch for smoking cessation. Because higher dose patches were being tested, only smokers of ≥30 cigs/day were included. Although smokers with current alcohol abuse or dependence were excluded, 15% of the smokers had a past (>1 year ago) Short Alcohol Dependence Data (SADD) score of ≥9 suggesting past alcohol problems. Heavy smokers with a past history of alcohol problems did not relapse sooner, were not less likely to be abstinent and did not benefit more from nicotine treatment or from higher doses than heavy smokers without this history. We conclude that a past history of alcohol problems per se does not predict inability to stop smoking.

Six-month outcomes of hospital-based psychiatric substance use consultations

Substance use disorders and their health complications are prevalent in general hospitals. Among intervention measures, specialized substance use consultations by a general hospital psychiatric consultation team have been described. Because outcome data are scanty, effectiveness of specialist consultations is not known. To analyze effectiveness of focused, semistructured consultations by clinically competent consultants, we conducted a prospective 6-month follow-up in a hospital-based psychiatric substance use consultation service. We aimed to measure severity of dependence and changes in substance use and to find out which variables at the consultation anticipated abstinence or reduction in substance use. Among general hospital patients referred for substance use consultation, 30% (46/155) of the male patients and 56% (35/63) of the female patients reported either abstinence or reduction in substance use at the 6-month follow-up. Changes in weekly alcohol consumption and SADD (Short Alcohol Dependence Data) scores were statistically significant ( P<0.001) and clinically highly meaningful. Absence of earlier psychiatric or substance use treatment and fewer adverse substance use consequences predicted reduction in substance use. Compliance and outcomes were remarkable among female patients, and improvement was promoted by unbroken family relations. In all, hospital-based psychiatric substance use consultations seemed to be effective as the only treatment among socially adjusted substance use patients, whereas patients with psychiatric comorbidity and/or chronic substance use problems needed more vigorous help.

Nondaily drinkers score higher on the Alcohol Dependence Scale than daily drinkers

To evaluate the relationship between drinking pattern and alcohol dependence severity, 209 individuals voluntarily seeking treatment for alcohol problems were administered the Alcohol Dependence Scale (ADS), the Short Alcohol Dependence Data (SADD) questionnaire, and a 12-month Timeline Follow-Back (TLFB) drinking assessment as part of their pretreatment assessment. Based on their TLFB data, participants were divided into two groups: daily (DD, n=84) and nondaily (NDD, n=125) drinkers. The two groups were compared on several demographic and drinking variables. It was hypothesized that DD would have higher scores on measures of alcohol dependence than NDD. However, the reverse pattern was found. The NDD had significantly higher ADS scores than the DD. An analysis of ADS subscale scores indicated that the primary difference between the two groups was in the domain of loss of behavior control. It is suggested that NDD may perceive intoxication as more impairing, perhaps because they have acquired less tolerance than DD. These results suggest that treatment focused on restoring a sense of behavior control would be beneficial for NDD.

Alcoholic women and men: a comparative study of social and familial aspects and outcome

Objective: Alcoholic men-women ratio has ranged from 14:1 to 2:1, suggesting that female alcoholism should be further studied. The purpose of the current study was to compare alcohol dependence severity and treatment outcome between alcoholic men and women. Methods: In this longitudinal study, 114 male and 57 female alcoholics (ICD-10 criteria), who started treatment between 1990 and 1994 at the Botucatu Medical School Outpatient Clinic, were retrospectively and prospectively assessed up to July 1997. Semi-structured interviews were conducted and the severity of alcohol dependence was assessed (Short Alcohol Dependence Data -- SADD). Results/Conclusions: The results showed poorly structured families, 55.6% of women and 65.7% of men reported relationship problems and 74.1% of women and 61.1% of men reported domestic violence. When compared to men, women started abusing alcohol later in life (p=0.01) and, usually, with their husbands (p=0.00). The course of treatment did not differ between genders. Regardless of gender, the main factors associated with a better response to treatment were: degree of alcohol dependence severity (mildly and moderately dependent users had 5.59-fold better chances of improvement than those severely dependent), religious practice (2.3-fold better chances of improving) and follow-up length, which was negatively associated with chance of improvement (0.68-fold less chance of improvement than those who remained under shorter treatment).