Alcohol and Drug Abuse
Hasin DS, Goodwin RD, Stinson FS, Grant BF. Arch Gen Psychiatry. 2005 Oct;62(10):1097-1106.
OBJECTIVE: To present nationally representative data on 12-month and lifetime prevalence, correlates, and comorbidity of DSM-IV major depressive disorder (MDD) among adults in the United States.
Design/Setting/ PARTICIPANTS: Face-to-face survey of more than 43 000 adults aged 18 years and older residing in households and group quarters in the United States.
MAIN OUTCOME MEASURES: Prevalence and associations of MDD with sociodemographic correlates and Axis I and II disorders.
RESULTS: The prevalence of 12-month and lifetime DSM-IV MDD was 5.28% (95% confidence interval, 4.98-5.57) and 13.23% (95% confidence interval, 12.64-13.81), respectively. Being female; Native American; middle-aged; widowed, separated, or divorced; and low income increased risk, and being Asian, Hispanic, or black decreased risk (P<.05). Women were significantly more likely to receive treatment than men. Both current and lifetime MDD were significantly associated with other specific psychiatric disorders, notably substance dependence, panic and generalized anxiety disorder, and several personality disorders.
CONCLUSIONS: This large survey suggests a higher prevalence of MDD in the US population than large-sample estimates from the 1980s and 1990s. The shift in highest lifetime risk from young to middle-aged adults is an important transformation in the distribution of MDD in the United States and specificity in risk for an age-period cohort. Associations between MDD and Axis I and II disorders were strong and significant, with variation within broad categories by specific diagnoses signaling the need for attention to the genetic and environmental reasons for such variation, as well as the implications for treatment response.
Epidemiology of Major Depressive Disorder: Results From the National Epidemiologic Survey on Alcoholism and Related Conditions
Effect of chronic alcoholism on male fertility hormones and semen quality
Muthusami KR, Chinnaswamy P. Fertil Steril. 2005 Oct;84(4):919-24.
OBJECTIVE: To evaluate the effects of chronic alcoholism on the male fertility hormones and quality of semen.
DESIGN: Non-probability purposive clinical study.
SETTING: Addiction treatment center and an academic research environment.
PATIENT(S): Sixty-six alcoholics free from smoking and drug abuse who consumed a minimum of 180 mL of alcohol per day (brandy and whisky, both 40%-50% alcohol content) for a minimum of 5 days per week for > or =1 year were included. Thirty nonsmoking nonalcoholics were selected as controls.
INTERVENTION(S): Before starting the addiction treatment for alcoholics, venous blood and semen samples were collected.
MAIN OUTCOME MEASURE(S): Complete blood counts, biochemical parameters, levels of the male fertility hormones FSH, LH, T, PRL, P, and E2 in blood, and semen parameters. RESULT(S): In alcoholics, FSH, LH, and E2 levels were significantly increased, and T and P levels were significantly decreased. No significant change was noted in PRL levels. Semen volume, sperm count, motility, and number of morphologically normal sperm were significantly decreased.
CONCLUSION(S): Chronic alcohol consumption has a detrimental effect on male reproductive hormones and on semen quality.
OBJECTIVE: To evaluate the effects of chronic alcoholism on the male fertility hormones and quality of semen.
DESIGN: Non-probability purposive clinical study.
SETTING: Addiction treatment center and an academic research environment.
PATIENT(S): Sixty-six alcoholics free from smoking and drug abuse who consumed a minimum of 180 mL of alcohol per day (brandy and whisky, both 40%-50% alcohol content) for a minimum of 5 days per week for > or =1 year were included. Thirty nonsmoking nonalcoholics were selected as controls.
INTERVENTION(S): Before starting the addiction treatment for alcoholics, venous blood and semen samples were collected.
MAIN OUTCOME MEASURE(S): Complete blood counts, biochemical parameters, levels of the male fertility hormones FSH, LH, T, PRL, P, and E2 in blood, and semen parameters. RESULT(S): In alcoholics, FSH, LH, and E2 levels were significantly increased, and T and P levels were significantly decreased. No significant change was noted in PRL levels. Semen volume, sperm count, motility, and number of morphologically normal sperm were significantly decreased.
CONCLUSION(S): Chronic alcohol consumption has a detrimental effect on male reproductive hormones and on semen quality.
Alcohol consumption among teenagers in Brazzaville (Congo)
Mabiala-Babela JR, Mahoungou-Guimbi KC, Massamba A, Senga P. Sante. 2005 Jul-Sep;15(3):153-60 (in French).
The objectives of the present paper are to assess the frequency of alcohol use among Congolese teenagers and to identify the epidemiological factors linked with problem drinking.
A cross-sectional survey, conducted throughout Brazzaville (Congo), targeted a representative sample of 4315 adolescents (1984 girls and 2334 boys), aged 10 to 19 years. Physicians from outside the area (to optimize confidentiality) interviewed the subjects according to a questionnaire that included both open and closed questions.
Overall, 984 teenagers (22.8%) were alcohol users. This frequency was higher among boys than girls, but not significantly. It was also higher among older teenagers (those aged 15-19 years compared with those aged 10-14 years, p < 0.001), those no longer attending school (compared with those still in school, p < 0.01), and those with no religious beliefs (p < 0.001). In addition, alcohol use was less prevalent among those living with their parents than among orphans (p < 0.001). Most subjects were moderate users, and the most common alcoholic beverage for both boys and girls was beer (95.4%). Episodes of drunkenness concerned more boys (49.2%) than girls (11.9%).
Our results show the value of epidemiological investigations for planning prevention programs and the need for such programs among these adolescents to prevent excess drinking and the numerous health problems associated with it.
The objectives of the present paper are to assess the frequency of alcohol use among Congolese teenagers and to identify the epidemiological factors linked with problem drinking.
A cross-sectional survey, conducted throughout Brazzaville (Congo), targeted a representative sample of 4315 adolescents (1984 girls and 2334 boys), aged 10 to 19 years. Physicians from outside the area (to optimize confidentiality) interviewed the subjects according to a questionnaire that included both open and closed questions.
Overall, 984 teenagers (22.8%) were alcohol users. This frequency was higher among boys than girls, but not significantly. It was also higher among older teenagers (those aged 15-19 years compared with those aged 10-14 years, p < 0.001), those no longer attending school (compared with those still in school, p < 0.01), and those with no religious beliefs (p < 0.001). In addition, alcohol use was less prevalent among those living with their parents than among orphans (p < 0.001). Most subjects were moderate users, and the most common alcoholic beverage for both boys and girls was beer (95.4%). Episodes of drunkenness concerned more boys (49.2%) than girls (11.9%).
Our results show the value of epidemiological investigations for planning prevention programs and the need for such programs among these adolescents to prevent excess drinking and the numerous health problems associated with it.
Clinical features of depressed patients with or without a family history of alcoholism
Sher L, Oquendo MA, Conason AH, Brent DA, Grunebaum MF, Zalsman G, Burke AK, Mann JJ. Acta Psychiatr Scand. 2005 Oct;112(4):266-71.
Objective: To compare clinical features of depressed subjects without alcoholism but with a family history of alcoholism to a depressed group without alcoholism and without a family history of alcoholism.
Method: Clinical and demographic data of 209 depressed subjects without a history of alcoholism in first-degree relatives and 73 depressed individuals with a history of alcoholism in first-degree relatives were compared. Subjects with a personal history of alcoholism were excluded.
Results: Depressed subjects with a family history of alcoholism have a significantly higher prevalence of reported childhood physical and sexual abuse and post-traumatic stress disorder (PTSD), make more suicide attempts, and have greater intent to die at the time of their most lethal suicide attempt, compared to depressed subjects without a family history of alcoholism.
Conclusion: Depressed patients with a family history of alcoholism are at greater risk for suicidal behavior and PTSD and may require more careful management.
Objective: To compare clinical features of depressed subjects without alcoholism but with a family history of alcoholism to a depressed group without alcoholism and without a family history of alcoholism.
Method: Clinical and demographic data of 209 depressed subjects without a history of alcoholism in first-degree relatives and 73 depressed individuals with a history of alcoholism in first-degree relatives were compared. Subjects with a personal history of alcoholism were excluded.
Results: Depressed subjects with a family history of alcoholism have a significantly higher prevalence of reported childhood physical and sexual abuse and post-traumatic stress disorder (PTSD), make more suicide attempts, and have greater intent to die at the time of their most lethal suicide attempt, compared to depressed subjects without a family history of alcoholism.
Conclusion: Depressed patients with a family history of alcoholism are at greater risk for suicidal behavior and PTSD and may require more careful management.
Cognitive biases toward alcohol-related words and executive deficits in polysubstance abusers with alcoholism
Noel X, Van der Linden M, d'Acremont M, Colmant M, Hanak C, Pelc I, Verbanck P, Bechara A. Addiction. 2005 Sep;100(9):1302-9.
AIM: To study cognitive biases for alcohol-related cues on executive function tasks involving mental flexibility and response inhibition in polysubstance abusers with alcoholism.
DESIGN: The responses to alcohol- related cues of detoxified polysubstance abusers with alcoholism and of non- addicts were compared.
SETTING: The University of Iowa City, Iowa, USA.
PARTICIPANTS: Thirty detoxified polysubstance abusers with alcoholism (PSA) and 30 healthy non-substance abusers (CONT).
MEASUREMENTS: Using the 'Alcohol Shifting Task', a variant of the go/no-go paradigm, we measured the response times and the accuracy of responses to targets and distracters. Sometimes the alcohol-related words were the targets for the 'go' response, with neutral words as distracters, sometimes the reverse. Several shifts in the type of the target occurred during the task.
FINDINGS: Relative to CONT, PSA were generally slower to respond to targets, but the group difference was smaller when alcohol- related words were the targets. A signal detection analysis also indicated that relative to CONT, the PSA had more difficulties discriminating between targets and distracters (low d'), and they showed more signs of decision bias (low C), reflecting increased readiness to respond to both targets and distracters. However, these discrimination and inhibition deficits were more pronounced when alcohol-related words were the targets. Furthermore, the weaknesses in RT and C were more pronounced in PSA after shifting the targets from alcohol-related to neutral words, or vice versa.
CONCLUSIONS: These results suggest that PSA have cognitive biases towards information related to alcohol, and that these biases, as well as the poor executive functions (lower mental flexibility and response inhibition) revealed in PSA might be responsible for their failure to maintain abstinence.
AIM: To study cognitive biases for alcohol-related cues on executive function tasks involving mental flexibility and response inhibition in polysubstance abusers with alcoholism.
DESIGN: The responses to alcohol- related cues of detoxified polysubstance abusers with alcoholism and of non- addicts were compared.
SETTING: The University of Iowa City, Iowa, USA.
PARTICIPANTS: Thirty detoxified polysubstance abusers with alcoholism (PSA) and 30 healthy non-substance abusers (CONT).
MEASUREMENTS: Using the 'Alcohol Shifting Task', a variant of the go/no-go paradigm, we measured the response times and the accuracy of responses to targets and distracters. Sometimes the alcohol-related words were the targets for the 'go' response, with neutral words as distracters, sometimes the reverse. Several shifts in the type of the target occurred during the task.
FINDINGS: Relative to CONT, PSA were generally slower to respond to targets, but the group difference was smaller when alcohol- related words were the targets. A signal detection analysis also indicated that relative to CONT, the PSA had more difficulties discriminating between targets and distracters (low d'), and they showed more signs of decision bias (low C), reflecting increased readiness to respond to both targets and distracters. However, these discrimination and inhibition deficits were more pronounced when alcohol-related words were the targets. Furthermore, the weaknesses in RT and C were more pronounced in PSA after shifting the targets from alcohol-related to neutral words, or vice versa.
CONCLUSIONS: These results suggest that PSA have cognitive biases towards information related to alcohol, and that these biases, as well as the poor executive functions (lower mental flexibility and response inhibition) revealed in PSA might be responsible for their failure to maintain abstinence.
The consumption of cigarettes, coffee and sweets in detoxified alcoholics and its association with relapse and a family history of alcoholism
Junghanns K, Backhaus J, Tietz U, Lange W, Rink L, Wetterling T, Driessen M. Eur Psychiatry. 2005 Aug;20(5-6):451-5.
Thirty male alcohol dependent inpatients without concurrent depressive disorder, 13 of them with a positive family history of alcohol dependence in a first degree relative (PFH), were questioned about their desire and consumption habits with respect to cigarettes, coffee, and sweets while on a three-week inpatient treatment after detoxification from alcohol.
Six weeks after discharge from hospital, the patients were reassessed for relapse.
Eleven patients (36.6%) had relapsed at follow-up. Relapsers were younger than abstainers.
The days until relapse correlated negatively with intensity of desire to drink alcohol, desire to smoke cigarettes, and with a higher consumption of cigarettes.
PFH patients did not relapse earlier but they had a stronger desire to drink coffee and eat sweets and had a higher coffee consumption.
Thirty male alcohol dependent inpatients without concurrent depressive disorder, 13 of them with a positive family history of alcohol dependence in a first degree relative (PFH), were questioned about their desire and consumption habits with respect to cigarettes, coffee, and sweets while on a three-week inpatient treatment after detoxification from alcohol.
Six weeks after discharge from hospital, the patients were reassessed for relapse.
Eleven patients (36.6%) had relapsed at follow-up. Relapsers were younger than abstainers.
The days until relapse correlated negatively with intensity of desire to drink alcohol, desire to smoke cigarettes, and with a higher consumption of cigarettes.
PFH patients did not relapse earlier but they had a stronger desire to drink coffee and eat sweets and had a higher coffee consumption.
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