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1.
The Obsessive-Compulsive Drinking Scale (OCDS) is a self-rating questionnaire that measures cognitive and behavioral aspects of craving for alcohol. The OCDS consists of two subscales: the obsessive thoughts of drinking subscale (OS) and the compulsive drinking subscale (CS). This study aims to validate the Japanese version of the OCDS. First, internal consistency and discriminant validity were evaluated. Second, a prospective longitudinal 3-month outcome study of 67 patients with alcohol dependence who participated in a relapse prevention program was designed to assess the concurrent and predictive validity of the OCDS. The OCDS demonstrated high internal consistency. The OS had high discriminant validity, while the CS did not. Twenty-three patients (34.3%) dropped out of treatment. These patients had significantly higher OS scores than those who completed the program. At 3 months, the relapse group had significantly higher OCDS scores than the no relapse group. Also, the OCDS score was higher in subjects who had early-onset alcohol dependence than late-onset dependence. The OCDS is useful for evaluating cognitive aspect of craving and predicts dropout and relapse.  相似文献   

2.
Sixteen patients with obsessive compulsive disorder and 16 mentally healthy control subjects of comparable gender, age, and educational level underwent psychometric testing with the Obsessive-Compulsive subscale of the Comprehensive Psychiatric Rating Scale, the Maudsley Obsessive-Compulsive Inventory, and the Obsessive subscale of the Lazare-Klerman-Armor (LKA) Personality Inventory. An interviewer also rated each subject as positive or negative for each of the five DSM-III elements of compulsive personality disorder. Patients scored significantly higher than controls on all measures except the Obsessive subscale of the LKA Personality Inventory, on which the controls actually scored slightly higher. The authors suggest that the failure of this last instrument to differentiate the subject groups can be interpreted as evidence against a continuum between a certain type of supposed normal personality pattern (obsessive or compulsive) and a corresponding psychopathologic state (obsessive compulsive disorder).  相似文献   

3.
Dopaminergic neurotransmission plays a crucial role in the genesis and maintenance of alcohol dependence. Epigenetic regulation via promoter specific DNA methylation of the dopamine transporter gene (DAT) may influence altered dopaminergic neurotransmission in alcoholism. Aim of the present study was to investigate DNA promoter methylation of DAT in early alcohol withdrawal and in relation to alcohol craving. We analyzed blood samples of 76 patients admitted for detoxification treatment and compared them to 35 healthy controls. Methylation specific quantitative real-time PCR was used to measure the promoter specific DNA methylation of the dopamine transporter. We assessed the extent of alcohol craving using the obsessive compulsive drinking scale (OCDS). Compared to healthy controls we found a significant hypermethylation of the DAT-promoter (Mann-Whitney U-test: p = 0.001). Ln-transformed methylation of the DAT-promoter was negatively associated with the OCDS (linear regression: Beta = −0.275, p = 0.016), particularly with the obsessive subscale (Beta = −0.300, p = 0.008). Findings of the present study show that the epigenetic regulation of the DAT-promoter is altered in patients undergoing alcohol withdrawal. Furthermore, hypermethylation of the DAT-promoter may play an important role in dopaminergic neurotransmission and is associated with decreased alcohol craving.  相似文献   

4.
Several authors have shown that alexithymia characterizes patients suffering from substance abuses. Moreover emotional and perceptual dependencies have also been described in these disorders. The aim of this study is to test two hypotheses: First that the emotional components of alexithymia and dependency were linked in alcoholics and secondly that the cognitive components of these two dimensions were also linked in these subjects. Two groups were recruited: 60 inpatients filled out the DSM IV criteria for alcohol dependence and 57 healthy subjects were the controls. All the subjects completed the following rating scales: the twenty items Toronto Alexithymia Scale (TAS-20), the Interpersonal Dependency Inventory (IDI), the Beck Depression Inventory, the Embedded Figures Test (EFT). Partial correlations (r Bravais Pearson), using BDI score as constant, were calculated. In normals the Feelings subscale of the TAS-20 correlated with the Lack of social self confidence subscale of the IDI (r = 0.43, p < 0.0018) and in alcoholics the Cognitive factor of the TAS-20 correlated with the Lack of social self confidence subscale (r = 0.41, p < 0.0018). Moreover in alcoholics, the cognitive factor of the TAS-20 correlated significantly with the EFT score (r = -0.35, p < 0.003). CONCLUSION: In alcoholics the cognitive component of alexithymia and the perceptual component of dependency were linked, independently of an associated depression. A particular cognitive style characterized by externality and field dependence could characterized dependent alcoholics.  相似文献   

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OBJECTIVE: The purpose of this study was to assess changes in the temperament and character patterns in subjects with obsessive-compulsive disorder (OCD) following the treatment for obsessive/compulsive and accompanying depressive symptoms. METHOD: Study subjects were 35 patients who met the DSM-IV criteria for OCD. All subjects were assessed with the Temperament and Character Inventory (TCI), the Yale-Brown Obsessive-Compulsive Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory before and after a 4-month treatment. RESULTS: Harm Avoidance (HA) scores in OCD subjects before treatment significantly decreased after treatment. However, the Self-Directedness scores, which were significantly lower than healthy comparison subjects before treatment, did not change. In addition, Reward Dependence scores in OCD subjects, which were not significantly different from healthy comparison subjects before treatment, significantly increased after treatment. CONCLUSION: The TCI pattern of untreated OCD subjects (high HA and low Self-Directedness, relative to healthy comparison subjects) and the decrease of HA scores and no change in Self-Directedness scores following a successful treatment suggest that temperaments are more amenable to treatment than characters.  相似文献   

7.
C677T mutation of the methylenetetrahydrofolate reductase gene remains a controversial risk factor for venous thrombosis in Whites. The prevalence of methylenetetrahydrofolate reductase C677T genotype and its association with vascular thrombosis are not well established in Chinese population. We conducted a case-control study to investigate the prevalence of methylenetetrahydrofolate reductase C677T gene mutation and its association with venous thrombophilia in Taiwanese Chinese. The subjects consisted of 112 venous thrombophilic patients and 125 healthy controls, with similar age (p=0.08) and sex (p=0.58). The prevalent rates of C/T heterozygote were 32.8 and 44.6%; whereas those of T/T homozygote were 6.4 and 8.0% in the controls and patients, respectively. Neither C/T heterozygote (odds ratio, 1.7; 95% confidence interval, 1.0-3.0, p=0.05] nor T/T homozygote (odds ratio, 1.4; 95% confidence interval, 0.5-4.0, p=0.5) was significantly associated with venous thrombosis. Even when only subjects (52 patients and 107 controls) with normal inhibitor protein levels were analyzed, the association of T/T homozygote with venous thrombosis remained insignificant (p=0.06) with an odds ratio (95% confidence interval) of 3.4 (0.99-11.7). We concluded that, in Taiwanese Chinese, methylenetetrahydrofolate reductase C677T mutation is a common genetic mutation, but T/T homozygote is not a significant risk factor for venous thrombophilia.  相似文献   

8.
The psychometric properties of the Obsessive Compulsive Inventory–Child Version (OCI-CV) were examined in ninety-six youth with a primary/co-primary diagnosis of obsessive–compulsive disorder (OCD). A confirmatory factor analysis revealed an acceptable model of fit with factors consisting of doubting/checking, obsessing, hoarding, washing, ordering, and neutralizing. The internal consistency of the OCI-CV total score was good, while internal consistency for subscale scores ranged from poor to good. The OCI-CV was modestly correlated with obsessive–compulsive symptom severity on the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) Severity Scale, as well as with clinician-reported OCD severity. All OCI-CV subscales significantly correlated with the corresponding CY-BOCS Symptom Checklist dimension. The OCI-CV significantly correlated with child-reported depressive symptoms and OCD-related functional impairment, but was not significantly correlated with parent-reported irritability or clinician-reported overall functioning. Taken together, these data suggest the psychometric properties of the OCI-CV are adequate for assessing obsessive–compulsive symptom presence among youth with OCD.  相似文献   

9.
BACKGROUND: Prolactin secretion is closely connected to dopaminergic transmission that is known to play a crucial role in mediating reinforcement and craving in alcoholism. OBJECTIVES: The study was performed to analyze the association between prolactin serum levels and alcohol craving during withdrawal differentiating alcohol-dependent patients using Lesch's typology. METHODS: We assessed 115 male patients with the Obsessive Compulsive Drinking Scale at early alcohol withdrawal. In addition, serum was obtained to measure prolactin concentration and the patients were classified according to Lesch's typology into one of four subgroups. RESULTS:Correlation analysis showed a significant association between prolactin serum levels and the extent of craving in Lesch's type 2 patients (r=0.32, p=0.015; n=57); however, no association was found for any other subgroup. The results were confirmed comparing patients with low and high craving (Mann-Whitney U test: Z=-2.805, p=0.005). CONCLUSIONS: In patients of Lesch's type 2, who are characterized to suffer from anxiety and to use alcohol because of its anxiolytic effects, prolactin is associated with craving during early alcohol withdrawal.  相似文献   

10.
OBJECTIVE: This 6-week open-label trial of naltrexone was conducted in a preliminary fashion to determine whether naltrexone would be safe, well tolerated, and lead to a reduction in alcohol consumption in adolescents with alcohol dependence. METHOD: Five outpatient treatment-seeking adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for alcohol dependence were recruited. The Child Schedule for Schizophrenia and Affective Disorders (K-SADS), Structured Clinical Interview for DSM (SCID), and the Family History Questionnaire were administered at baseline. The Time-Line Follow-Back (TLFB) and two craving scales (Adolescent Obsessive Compulsive Drinking Scale [A-OCDS] and a craving analog scale) were administered at baseline and weekly thereafter. Each subject received a 10-day supply of naltrexone (50 mg) and a 100-mg riboflavin capsule. Subjects were instructed to take naltrexone and riboflavin simultaneously. RESULTS: Overall, the average drinks per drinking day (DDD) decreased significantly from baseline to the end of week 6 with an average reduction of 7.61 standard drinks. There was a significant reduction in the average A-OCDS total score, A-OCDS Irresistibility subscale score, and craving analog score. Nausea was the only side-effect reported, and there were no elevations of liver enzymes. Naltrexone was well tolerated by the alcohol-dependent adolescent. CONCLUSIONS: Our data suggest that naltrexone is safe and well tolerated in adolescent alcoholics. Naltrexone may lead to a significant reduction in alcohol consumption and craving in adolescent alcoholics, but larger, randomized, controlled trials are needed.  相似文献   

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