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1.
A genetic epidemiological case-control study on aldehyde dehydrogenase 2 (ALDH2) genotype and male probable alcohol use disorders (AUD) was performed in Khon Kaen province, northeast Thailand. One hundred and twenty-four of cases (probable AUD) were obtained from male villagers aged 18-65 years using the modified Michigan Alcoholism Screening Test-Thai version. The same number of controls were selected, being matched with the cases in terms of age (+/-4 years) within the same village. Marital status, education history and past or present histories of physical illnesses were essentially the same for the cases and the controls. All of the cases and 85.5% of the controls were current drinkers, and the cases tended to drink significantly more often than the controls. Genomic DNA was extracted from fingernails and ALDH2 genotypes were determined by polymerase chain reaction technique and digested by Ksp 632I. The ALDH2 genotypes of the cases and the controls were not significantly different: 90.3% versus 91.1% normal homozygote; 8.1% versus 8.9% heterozygote; and 1.6% versus 0.0% mutant homozygote, respectively. Among the normal homozygote, the daily amount of alcohol intakes of the cases were significantly larger than that of the controls (56.2+/-40.6g vs. 8.1+/-14.1 g), the same was found among the ALDH2 deficient (55.9+/-43.4 vs. 2.2+/-5.8 g). Multivariate analysis based on the conditional logistic regression model showed no significant association of AUD with ALDH2 genotype, marital status, education history, or past history of injury, however, occupation and daily amount of alcohol intake were found to be significantly associated with AUD (OR = 10.72, 95% CI = 1.15-99.99, P = 0.037, and OR = 1.12, 95% CI = 1.06-1.18, P = 0.000, respectively). Non-farmers showed 10.7 times larger risk of developing AUD compared to farmers, and the subjects had three times more chance of developing AUD for each increase of 10 g of the daily amount of alcohol intake.  相似文献
2.
Thirty subjects with comorbid schizophrenia and alcohol use disorders were randomly assigned to receive either a Motivational Interviewing (MI) or Educational Treatment (ET) intervention with treatment goals of abstinence and/or decreased alcohol use. Subjects were followed up at 4, 8 and 24-weeks upon completion of the interventions. Outcome measures included number of drinking days, abstinence rates, average blood alcohol concentration and standard ethanol content per drinking day. Subjects randomized to the MI intervention had a significant reduction in drinking days and an increase in abstinence rates when compared to subjects receiving ET. Motivational Interviewing may be a useful treatment intervention for individuals with schizophrenia and alcoholism.  相似文献
3.
A case-control study on the relationship between alcohol dehydrogenase-2 (ADH2), aldehyde dehydrogenase-2 (ALDH2) and male probable alcohol use disorders (AUD) was performed in Khon Kaen, north-east Thailand. One hundred and fifty-three paired cases (probable AUD) and controls (non-probable AUD) were sampled from villagers aged 18-65 years using the modified Michigan Alcoholism Screening Test - Thai version, controls being matched for gender, age (+/- 4 years) and village. All of the cases and 86.9% of the controls were current drinkers. The percentage of ADH2*1/1 among cases was 47.1%, being significantly larger than the 29.4% among controls, and yielding a univariate odds ratio (OR) of 2.421* (95% confidence interval (CI) = 1.419-4.132) for developing probable AUD. The ALDH2*1/1 proportion among cases, 92.8%, was comparable to the 92.2% among controls, yielding a univariate OR of 1.100 (95%CI = 0.757-1.599). Multivariate analysis based on a conditional logistic regression model and a hierarchically well-formulated model strategy revealed that: (i) the OR of developing probable AUD due to 1 g increment of daily ethanol drinking was 1.110* among farmers (95%CI = 1.054-1.170); (ii) OR due to 1 g increment of daily ethanol drinking was 1.329* among non-farmers (95%CI = 1.109-1.593); (iii) OR due to either ADH2*1/1 or ALDH2*1/1 was insignificant; and (iv) the daily amount of smoking is independently associated with probable AUD. The present findings suggest that one of the genetic factors that may be related to probable AUD among Thai males living in the north-east is the ADH2 gene.  相似文献
4.
Objective:  Bipolar disorder is associated with a high frequency of both completed suicides and suicide attempts. The primary aim of this study was to identify clinical predictors of suicide attempts in subjects with bipolar disorder.
Methods:  We studied 336 subjects with a diagnosis of bipolar I, bipolar II, or schizoaffective disorder (bipolar type). The Structured Clinical Interview for DSM-IV (SCID-I) was administered and subsequently two expert psychiatrists established a diagnosis. Predictors of suicide attempts were examined in attempters and non-attempters.
Results:  The lifetime rate of suicide attempts for the entire sample was 25.6%. A lifetime co-morbid substance use disorder was a significant predictor of suicide attempts: bipolar subjects with co-morbid substance use disorders (SUD) had a 39.5% lifetime rate of attempted suicide, while those without had a 23.8% rate (odds ratio=2.09, 95% CI=1.03–4.21, χ2=4.33, df=1, p=0.037).
Conclusions:  Lifetime co-morbid SUD were associated with a higher rate of suicide attempts in patients with bipolar disorder. This relationship may have a genetic origin and/or be explained by severity of illness and trait impulsivity.  相似文献
5.
The objective was to explore psychiatric disorders as potential predictors of sleep duration. A cross-sectional survey study with a probability sample of residents of a northern German area was carried out. There were 4075 study participants, aged 18–64 years, with a participation rate of 70.2%. Face-to-face in-home computer-aided interviews (Composite International Diagnostic Interview) provided diagnoses of nicotine and alcohol dependence, alcohol abuse, depressive, anxiety and somatoform disorders according to the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV), and included questions about sleep duration. Results show that subjects with a short sleep duration of 5 h or less had significantly increased odds ratios (OR) for current nicotine dependence (OR 1.9,; confidence interval, CI, 1.2–2.9), alcohol dependence (OR 2.6, CI 1.2–5.6), depressive disorder (OR 3.0, CI 1.7–5.4) or anxiety disorder (OR 2.1, CI 1.3–3.4) compared to individuals who never had the respective psychiatric disorder after adjustment for sex, age, and school education in a multinomial regression analysis. The conclusion is drawn that current nicotine or alcohol dependence, depressive, and anxiety disorders may add to short sleep duration in this random adult general population sample.  相似文献
6.
Abstract Background This study investigated the prevalence of alcohol use disorder in a Korean community and compared the results with 1984 epidemiological data. Method A sample of 1,059 residents aged 18–64 years was interviewed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The results obtained were compared with those of a 1984 epidemiological study. Results Lifetime prevalence of alcohol use disorder was 15.6% (abuse 6.8%, dependence 8.8 %) and 1-year prevalence 7.5% (abuse 2.5%,dependence 5 %).The male-to-female ratio of life-time prevalence was 5.8,which markedly decreased with decreasing age. A cohort effect, i. e. increases of lifetime prevalence in younger cohorts, was observed, with the exception of the 60- to 64-year-old cohort. The mean age of onset was 27.7 years (male 28.2 years, female 24.2 years). When the results of the present study were compared with those of the 1984 study, it was found that, during the past 15 years, lifetime prevalence has decreased, prevalence ratios of abuse and dependence have become reversed, and the male-to-female ratio has decreased. Conclusion Remarkable changes in the pattern of prevalence, which have occurred between 1984 and 1999, may be attributed to significant sociocultural changes and to a decrease in the proportion of a high-risk cohort in the populations.  相似文献
7.
OBJECTIVES: Alcohol use disorders (AUDs) are common co-occurring conditions in patients with bipolar disorder (BD), but it is unclear whether or not AUD and BD symptoms are temporally correlated. The primary aim of this analysis was to examine concurrent symptom tracking and how the relative onsets of AUD and BD influence the concurrent tracking of symptoms. METHODS: Participants met DSM-IV criteria for bipolar I disorder, manic or mixed, with no prior hospitalizations and minimal treatment. Patients were rated for alcohol use and bipolar symptom severity on a weekly basis for up to 7 years. For analysis purposes, patients were placed into groups with no AUD (BD Only; n = 21), onset of AUD either concurrent with or after the onset of bipolar symptoms (BD First; n = 32), and onset of AUD at least 1 year before the onset of bipolar symptoms (AUD First; n = 18). RESULTS: None of the patient groups demonstrate consistent positive or negative temporal correlations between alcohol use and affective symptoms. However, there were significant between-group differences on the relationship of symptom tracking and age of BD onset. For the AUD First group, the correlation between age of BD onset and symptom tracking was positive 0.41. However, for the BD First and BD Only groups the correlations were negative (-0.32 and -0.41, respectively). Moreover, for patients whose BD onset was < or =18 years old, the correlation between age of onset and tracking was -0.47. CONCLUSIONS: These findings suggest that although there is no direct temporal correlation of AUD and BD symptoms in subgroups of BD patients, age at illness onset contributes to the complex relationship between BD and AUD. For younger patients there may be a greater likelihood that alcohol use and bipolar symptoms increase or decrease in unison.  相似文献
8.
The pharmacological armamentarium for the maintenance of alcohol abstinence in patients with alcohol use disorder has not gained widespread dissemination and novel molecular targets for the medical treatment of alcohol use disorder are needed. Glucagon-like peptide-1 (GLP-1) is an incretin hormone, which is secreted from endocrine L cells of the intestine in response to nutrients in the gut lumen. Recent studies have demonstrated inhibitory effects of GLP-1 analogues on alcohol consumption and alcohol-mediated behaviour in rodents. Based on the urgent need for novel pharmacological treatment strategies for alcohol use disorder and the promising pre-clinical data on the effects of GLP-1-analogues on alcohol consumption, we suggest that clinical trials rigorously testing whether GLP-1 analogues will reduce alcohol consumption in alcohol use disorder patients should be carried out.  相似文献
9.
Drug addiction is a chronically relapsing disorder characterized by loss of control over intake and dysregulation of stress-related brain emotional systems. Since the discovery by Wylie Vale and his colleagues of corticotropin-releasing factor (CRF) and the structurally-related urocortins, CRF systems have emerged as mediators of the body’s response to stress. Relatedly, CRF systems have a prominent role in driving addiction via actions in the central extended amygdala, producing anxiety-like behavior, reward deficits, excessive, compulsive-like drug self-administration and stress-induced reinstatement of drug seeking. CRF neuron activation in the medial prefrontal cortex may also contribute to the loss of control. Polymorphisms in CRF system molecules are associated with drug use phenotypes in humans, often in interaction with stress history. Drug discovery efforts have yielded brain-penetrant CRF1 antagonists with activity in preclinical models of addiction. The results support the hypothesis that brain CRF–CRF1 systems contribute to the etiology and maintenance of addiction.  相似文献
10.

Objective

The objective was to establish the prevalence and risk factors for multiple chronic medical conditions (MCMC) in the Singapore population.

Methods

Data for the study were extracted from the Singapore Mental Health Study, a population-based, cross-sectional, epidemiological study of Singapore residents aged 18 years and above. Face-to-face interviews were completed with 6616 respondents from December 2009 to December 2010, and the survey response rate was 75.9%. The assessment of psychiatric conditions was established using version 3.0 of the WHO World Mental Health Composite International Diagnostic Interview (WMH-CIDI). A modified version of the CIDI checklist of chronic medical conditions was used to capture data on 15 chronic medical conditions which were reclassified into eight types of physical conditions.

Results

A total of 25.4% of the population reported having one chronic condition, and 16.3% had MCMC. Those who were older (aged 35 years and above vs. those aged 18–34 years), economically inactive, unemployed, overweight and obese had higher odds of having MCMC. Adjusting for covariates in multinomial regression analyses, mood and alcohol use disorder (AUD) were significantly associated with higher risk of MCMC.

Conclusions

The study identified two important yet potentially modifiable risk factors for MCMC — psychiatric conditions and obesity — in the general population. Screening for mood and alcohol use disorder, as well as lifestyle interventions targeted at obesity, must be a part of disease management for MCMC.  相似文献
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