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WORLD HOSPITAL DIRECTORY
Addiction Medical Alcohol and Alcoholism - current issue
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objective</div>Many genetic studies of psychiatric disorders rely on participants to mail in DNA samples. Differences in who returns a sample may affect the generalizability of these studies, but little attention has focused on possible differences between participants who do and do not provide samples. The present study compared participants with severe lifetime alcohol use disorder (AUD) who did and did not return saliva DNA samples.<div class="boxTitle">Methods</div><span style="font-style:italic;">N</span> = 3927 individuals were recruited through Facebook for a genome-wide association study of severe AUD. Participants completed an online survey and agreed to provide a saliva DNA sample by mail. Survey measures included: demographics, quantity and frequency of recent alcohol and tobacco use, impulsivity, and personality. Participants who returned the saliva kit (<span style="font-style:italic;">n</span> = 2412) were compared to those who did not provide DNA samples (<span style="font-style:italic;">n</span> = 1515) were compared using univariate Chi-square and <span style="font-style:italic;">t</span>-tests.<div class="boxTitle">Results</div>The sample was predominantly White (88.3%) and female (64.0%). DNA providers were more likely than non-providers to report graduate-level education. DNA providers were also less likely to report recent cigarette smoking and scored higher on measures of conscientiousness, perseverance, and premeditation. Using multivariate regression, the most parsimonious model found that being male, a non-smoker, and endorsing perseverance was associated with providing DNA.<div class="boxTitle">Conclusions</div>In an online sample of individuals with severe AUD, participants who did not provide DNA samples showed multiple demographic and psychosocial differences from those who did provide samples. These findings may have implications for generalizability and suggest that further research is needed.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Dividing participants of Temporary alcohol Abstinence Challenges (TACs) into subgroups can improve intervention effectiveness by identifying individuals who require extra support. In a previous study, participant subgroups were identified based on determinants of behaviour change, including drinking refusal self-efficacy, craving, and behavioural automaticity. However, the predictive value of these subgroups for TAC success remains unknown. This study examined their predictive value for (i) abstinence during a TAC and (ii) changes in drinking behaviour.<div class="boxTitle">Methods</div>Data were analysed from 1800 Dutch TAC participants who completed baseline and eight-month follow-up questionnaires. Binary logistic regression assessed the effect of subgroup on abstinence. Ordinal and binary logistic regressions within Generalized Estimating Equation models examined subgroup effects on drinking behaviour changes, including drinking frequency, glasses per drinking day, and excessive volumes.<div class="boxTitle">Results</div>TAC subgroups differed in abstinence and in changes in drinking frequency and glasses per drinking day on weekdays. ‘Habitual drinkers with perceived control to refuse’ and ‘drinkers in control’ were more likely to abstain during the challenge than ‘ordinary drinkers’, whereas ‘drinkers not in control’ were less likely to abstain. ‘Drinkers in control’ showed smaller reductions in drinking frequency and glasses per drinking day on weekdays compared with ‘ordinary drinkers’. No significant differences were found in changes in excessive drinking volumes and glasses per drinking day on weekends.<div class="boxTitle">Conclusions</div>This study demonstrated the predictive value of subgroups for abstinence but found limited predictive value for changes in drinking behaviour after the challenge. Future research could explore personalized support to optimize behaviour change.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background and Aims</div>Despite the critical importance of alcohol abstinence for patients with advanced liver disease, rates of returning to alcohol remain high and engagement with relapse prevention interventions is low. This study explores the potential barriers to relapse prevention in these patients.<div class="boxTitle">Methods</div>Semi-structured interviews were conducted with patients who had alcohol-related cirrhosis or alcohol-associated hepatitis. Interviews took place during a hospital admission. The study methodology was informed by a constructivist grounded theory approach.<div class="boxTitle">Results</div>Thirty-three participants were recruited from two sites. Participants had a mean age of 52 (range 30–60) and there were 10 female participants (30%). Most participants were actively drinking alcohol at time of admission (<span style="font-style:italic;">n</span> = 26) and 16 participants were interviewed during their index admission with alcohol-related liver disease.A renewed understanding of the health risk posed by future alcohol made participants confident that they would not return to alcohol use and participants felt that the most important factor in relapse prevention was their own motivation and willpower. However, many rejected the identity label of ‘alcoholic’ and drew a distinction between themselves and ‘bad drinkers’. These factors combined to create a barrier to relapse prevention therapies, since participants felt these were neither appropriate nor necessary for them.<div class="boxTitle">Conclusions</div>Enhanced self-efficacy, a belief in the importance of willpower, and a rejection of the alcoholic identity can together act to reduce engagement in relapse prevention in patients with advanced liver disease. Relapse prevention interventions should be reframed or redesigned to address these barriers.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>As a serious public health problem, alcoholic cardiomyopathy (ACM) has caused a heavy burden of disease.<div class="boxTitle">Methods</div>To summarize and deeply analyze the development trend of ACM at the global, regional, and national levels in the past 30 years, this study used the age-period-cohort model to analyze the age, period, and cohort effects of the prevalence, deaths, and disability-adjusted life years (DALYs) of ACM.<div class="boxTitle">Results</div>The results found that the overall time trend of ACM prevalence, deaths, and DALYs had been decreasing worldwide, but the opposite trend was observed in some countries and regions. The disease burden of male ACM patients was significantly higher than that of female patients. Moreover, the ASRs of prevalence, deaths, and DALYs for ACM were positively correlated with sociodemographic index levels. Finally, this study predicted that ACM prevalence will continue to decline over the next 10 years, while death rates and DALYs are expected to increase.<div class="boxTitle">Conclusions</div>Overall, the results of this study provided an insightful, up-to-date global perspective on time trends in ACM-related disease burden, shedding light on the inadequacy of ACM prevention, control, and intervention programs at multiple levels.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Aims</div>Economic development leading a country from a low- to middle-income status is usually associated with increases in alcohol consumption and decreases in all-cause mortality, despite increases in alcohol-attributable mortality. We analyzed this tradition for India during the years 2000–19, with attention to alcohol policy.<div class="boxTitle">Methods</div>Joinpoint analysis identified points of trend change and associated slopes for alcohol-attributable mortality and burden (disability-adjusted life years) between 2000 and 2019. Structural equation modeling assessed the relationship among adult alcohol <span style="font-style:italic;">per capita</span> consumption, gross domestic product <span style="font-style:italic;">per capita</span> at purchasing power parity (GDP-PPP <span style="font-style:italic;">per capita</span>), alcohol-attributable mortality, and all-cause mortality, where mortality rates were log-transformed in the models. Pearson correlation was evaluated among study variables. Literature review examined alcohol policies in India.<div class="boxTitle">Results</div>During the first decade between 2000 and 2019, a rapidly and steadily increasing GDP-PPP <span style="font-style:italic;">per capita</span> was associated with marked increases in alcohol consumption and decreases in all-cause mortality, despite increasing alcohol-attributable mortality. After 2010, the economic growth still increased, but the increase in alcohol consumption halted, likely due to strong alcohol control policies in availability restrictions (dry states, dry periods, high legal purchasing age and restrictions in density, and purchasing hours), as well as a high tax share on final price.<div class="boxTitle">Conclusion</div>Alcohol policies seem to have prevented further increases in alcohol consumption and attributable harm and thus should be upheld. Otherwise, increases in these harms will prevent India from fully reaping the health benefits of economic development.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Developed over nine decades ago, the 12 Steps were intended to provide structured and clear guidelines to promote recovery from alcohol use. The steps are designed to help individuals find a sense of purpose, meaning, and hope. The 12 Steps are meant to be guides for an ongoing process or spiritual progress. A more concrete way of understanding the steps relative to spiritual principles may be instructive for those working the steps and seeking a fulfilling meaning and purpose for their lives.<div class="boxTitle">Purpose</div>This paper provides a framework for understanding the 12 Steps in accord with four principles of spirituality: awareness, acceptance, interdependence, and self-transcendence.<div class="boxTitle">Methodology</div>A matrix was developed using each of the four principles of spiritualty. Each word or phrase from each of the 12 Steps was assigned to one principle. Examples for key words or phrases were provided.<div class="boxTitle">Results</div>Each of the 12 Steps are mapped to the four principles of spirituality, with annotations.<div class="boxTitle">Conclusions</div>The resulting guide serves as a concrete and instructive guide to understanding the spiritual nature of the 12 Steps.</span>
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