DRINKING PATTERNS AND BEVERAGE PREFERENCES OF LIVER CIRRHOSIS PATIENTS IN MEXICO

The purpose of this study was to investigate the pattern of alcoholism in a special group of alcoholics (alcoholic cirrhotics) in a hospital-based population in west central México and assess the role of regional spirits such as tequila. A complete alcohol drinking history and a structured questionnaire directed at investigating the pattern of alcohol consumption was applied to124 adult patients with chronic liver disease caused by alcohol during January1995 to January 1996.

The mean age of onset was 27 ± 3 years in women and 18 ± 0.5 years in men. The mean alcohol intake per week was 749 ± 192g for women and 1113 ± 151g for men. On average, patients consumed alcohol for a mean of 24.5 years. The overall patient drinking preference was for tequila followed by 96° Gay Lusac (G.L.), alcohol, and beer. In a subset of 70 patients three phases of alcoholism could be identified (prealcoholic, critical, and chronic). Each phase had a mean duration of at least 11 years.Beer was the dominant beverage in the prealcoholic phase while tequila was consumed more often in the other phases. In the critical phase of alcoholism an average of 337g of alcohol were consumed per week and in the chronic phase1765g/week.

Tequila was the overall preferred beverage in this group of alcoholics.Other beverages included beer and straight alcohol with a clear trend from less to higher concentration of alcohol throughout the drinking history. Subtle gender differences in the patterns of alcoholism may be suspected. In this group of patients the role of tequila drinking is highlighted.     

Alcohol consumption and academic performance in a population of Spanish high school students

OBJECTIVE: The present study was designed to identify patterns of alcohol consumption among Spanish high school students and describe the relationship between alcohol intake and school performance. METHOD: The sample population consisted of students, aged 14 to 19 years, who were attending high school during the academic year 1994-95 in the city of Granada in southern Spain. We studied 1,602 (861 female) students (alpha error - 0.05, sampling error = 5%), using a self-administered questionnaire that contained items about individual and family demographics, quantity and frequency of alcohol consumption, and school performance. Total alcohol consumption was recorded as grams (g) of alcohol per week and per day for three categories of alcoholic drinks: wine, beer and distilled spirits. RESULTS: The percentage of nondrinkers was 21.05% for male adolescents and 28.56% for female adolescents. The mean amount of alcohol consumed per week was larger in male than in female students (F= 18.36, l/l,594 df, p < .001) and distilled spirits accounted for the largest proportion of alcohol consumed. No significant differences in drinking patterns were found between students at public and private schools. The risk of academic failure increased considerably when more than 150 g of alcohol were consumed per week (OR: 2.91; 95% CI: 1.94-4.43). CONCLUSIONS: Although we cannot draw any conclusions about the causes of the association between academic failure and teenage drinking, our results do show that the risk of failing increases together with alcohol intake. However, it should be noted that academic achievement is also influenced by many factors other than alcohol consumption.     

Ethnic Origin,Beverage Preference,and Group Composition in Relation to Alcohol Consumption by Problem Drinkers

New Zealand problem drinkers of European, Maori, and Pacific Island origin did not differ in their mean alcohol consumption during a 2½-h free-drinking period in an experimental bar. Europeans had a smaller beer sip size, ingested more alcohol in the form of spirits, and were more likely to drink both beer and mixed drinks during the session than Polynesians. Dual beverage drinkers consumed more alcohol than did single beverage drinkers. Among drinkers of each ethnic category there was a positive relationship between alcohol consumption and ethnic representation in the drinking group. The results are discussed in the context of earlier baseline studies of drinking by alcoholics and normal drinkers, and observations of different ethnic groups drinking in the natural barroom environment.     

Drinking course in alcohol-dependent men from adolescence to midlife

OBJECTIVE: Most studies of alcoholism course are based on clinical populations (characterized by severe and chronic alcohol-related problems) or community samples generally covering a short period of time. The current study assessed variations in drinking behaviors from adolescence to midlife in a community sample, describing age of "drinking firsts" (e.g., first alcoholic drink) as well as frequency and duration of periods of abstinence, alcohol dependence (AD) and nonproblem drinking. METHOD: Participants were 354 males with lifetime diagnoses of AD (mean age 50.35) from the Vietnam Era Twin Registry who were assessed regarding alcohol use, abuse and dependence histories (DSM-IV). Using a modified version of Skinner's Lifetime Drinking History, drinking history was reported in terms of distinct drinking periods (phases). RESULTS: Participants reported, on average, 4.18 phases, each lasting 8.22 years, and 12.78 years of AD. More than 60% experienced increases in AD symptoms at least once in successive phases, but only a third of those increases were extreme. In contrast, extreme decreases in AD symptoms were reported by more than 50% of participants. Further, half indicated that they had transitioned from both fewer to greater and from greater to fewer AD symptoms during their drinking years; 8.2% reported no changes in AD symptoms. CONCLUSIONS: Results reflect a wide variation in drinking behaviors among AD men as well as frequent fluctuations in course within individuals' drinking histories. Findings do not support a universal developmental model of alcoholism; notably, they provide counterevidence to the disease model concept of alcoholism course as progressive and chronic.     

A clinical assessment of the consequences of alcohol consumption in 'communal' drinkers in the Zimbabwean Midlands.

The study was undertaken to clinically assess the consequences of alcohol consumption in 'communal' drinking patients whose levels of alcohol consumption could not be determined accurately in grams of alcohol. The level of alcohol consumed by 100 adult 'communal' drinking medical patients per drinking session was scored on a scale 0-10. The score was based on a qualitative impression of how much alcohol was drunk, level of consciousness, behaviour and gait. The frequency of drinking days in a week was scored on a 0-7 scale. The duration of drinking in years prior to registration at the clinic was also recorded. The pattern of diseases among the drinkers was compared to that of 70 adult non-drinkers. The individual diseases were ranked to association with alcohol consumption by the Kruskal-Wallis Test. The drinkers attained a mean level score of 5.75 +/- 2.16, a frequency of 4.75 +/- 2.4 days but the duration of prior drinking varied greatly. Gout, dilated cardiomyopathy, epilepsy and hypertension ranked highest in that order to alcohol usage. Rheumatic heart disease and Diabetes mellitus ranked low. The probability significance were, for level score p = 0.005, frequency p = 0.016 and duration p = 0.001. This method was able to identify the morbid chronic medical diseases associated with alcohol usage in 'communal' drinkers. There is a need to evaluate it against a known screening instrument like the Alcohol Use Disorders Identification Test (AUDIT).     

Differences and similarities in development of drinking behavior between alcoholic offspring of alcoholics and alcoholic offspring of non-alcoholics.

Self-reported initial, early, and long-term drinking behaviors, experiences, and consequences were obtained from male alcoholics completing inpatient treatment. Subjects were recruited and selected on the basis that they met DSM-III criteria for diagnosis of alcohol dependency and that their biological fathers were alcoholic (FHP; Family History Positive) or that they had no biological family history of alcoholism (FHN; Family History Negative). Results indicated that FHP subjects rated their initial taste of beer higher than FHN subjects, that FHP subjects began tasting and subsequently regularly drinking alcohol at an earlier age than FHN subjects and that there was significantly shorter elapsed time between initiating regular drinking and developing alcoholic-symptomatic problems in living among FHP alcoholics than FHN alcoholics. Although there were a few other significant differences, the drinking-behavioral histories of the two groups were remarkably similar and parallel. Taken together, results suggest that familial risk factors primarily influence the rate at which alcoholic drinking and alcoholism develop, rather than the form or pattern of alcoholic drinking.     

Influence of social setting and social drinking stimuli on drinking behavior

The present study examined the influence of social setting cues and alcohol drinking cues on the drinking rate and amount of beer consumed by social drinkers (college age males). The design consisted of three experimental conditions (N = 8); a social drinking condition in which the individual drank beer in the company of a beer drinking partner, a social setting condition in which the individual drank with a nondrinking partner, and a solitary setting, control condition. Analyses of variance revealed a significant group effect for amount of alcohol consumed, P <.05, and for sip rate, P <.05, suggesting that social setting cues were discriminate for higher rates and larger amounts of alcohol consumption by social drinkers. These findings are inconsistent with the negative findings reported by Foy & Simon (1978) in their comparison of drinking behavior of alcoholics in social vs. solitary settings. Further research is recommended in order to replicate the obtained findings with alcoholics, as well as with social drinkers, while extending the drinking interval beyond 50 minutes.     

Relationship between plasma adrenocorticotrophic hormone and cortisol concentrations in chronic alcoholic patients with depression

In 20 hospitalized male chronic alcoholic patients, plasma adrenocorticotrophic hormone (ACTH) levels were estimated by radioimmunoassay and cortisol levels by the competitive protein binding (CPB) method with radioactive selenium-75 on admission and during abstinence along with rating of the degree of depression immediately after the acute phase of the ethanol withdrawal syndrome was over. Duration of drinking ranged from 5 to 25 years and average daily ethanol intake was between 100 and 150 g. Plasma ACTH levels were found to be raised in drinking chronic alcoholics. There was a positive and statistically significant correlation between depression ratings and plasma ACTH concentrations (r = + 0.379; P less than 0.05). In chronic alcoholism the negative feedback mechanism seems to be disturbed between plasma ACTH and cortisol levels which are not normalised after 1 week of total abstinence. Chronic ethanol ingestion might have a direct stimulatory effect on the adrenal cortex leading to dysregulation of the hypothalamo-pituitary-adrenocortical axis.     

Quantitative measure of muscle strength and size in chronic alcoholism: an early indication of tissue damage

We measured quadriceps strength and thickness in 101 male alcoholic patients and in 58 controls in order to investigate the force-size relationships of skeletal muscle in an alcoholic population. The relationship of these parameters with the duration of alcoholism, nutritional status and biochemical and haematological markers of heavy chronic alcohol use was investigated. Alcohol consumption of more than 42 standard drinks (420 g alcohol) per week for at least 5 years is associated with muscle weakness and wasting. There was no evidence of under-nutrition in these alcoholic subjects and muscle wasting occurred independently of peripheral neuropathy, a history of muscle pain, abnormalities of liver enzymes and elevation of mean red cell corpuscular volume. Quantitation of muscle size and strength in heavy drinkers may provide a useful early indicator of health impairment in alcoholics.     

Outcome of treatment in alcoholic women.

One hundred and seventy-eight females (mean age 40.6 +/- 10.2 years) were retrospectively studied by questionnaires for a mean duration of 46 (17-75) months. Sixty-two percent were married or living maritally. One third were working. The mean alcohol intake was 157 +/- 76 g/day and 57.3% had alcohol dependence for less than 5 years. Twenty-seven patients (15%) were lost to follow-up; out of the 151 remaining patients, 7 (4%) refused to answer and 18 (12%) died. Suicide and alcoholism complications were a frequent cause of death. One hundred and twenty-six questionnaires were obtained. Twenty-eight women (22%) were abstinent. A good outcome determined by the state of alcoholization (abstinence or moderate consumption) and the improvement of quality of life, was found in 44% of patients. Absence of marital life and greater alcohol intake were related to a poor outcome, whereas enrollment in a fellowship of recovering alcoholics was more frequent in abstinent patients. The mortality rate was important in alcoholic females. A number of factors were related to the outcome.     

DRINKING AND PARENTAL UNPREDICTABILITY AMONG ADULT CHILDREN OF ALCOHOLICS: A PILOT STUDY

Within-family differences that mediate the relationship between family history for alcoholism and alcohol consumption were investigated. Twenty adult children of alcoholics (ACOAs) and 20 children of social drinking parents (non-ACOAs) were interviewed in 1991 (mean age 24.2 years). Participants described family functioning while growing up and indices of their alcohol consumption. Family history for alcoholism had a direct association with two aspects of drinking. ACOAs reported more lifetime drinks and tended to report drinking more frequently during high school, as compared to non-ACOAs. ACOAs also reported more parental unpredictability, which in turn was associated with the above drinking indices. Finally, family history for alcoholism had an indirect association with drinking, as unpredictability mediated this relationship. Research and prevention implications are discussed.     

Drinking and parental unpredictability among adult children of alcoholics: a pilot study.

Within-family differences that mediate the relationship between family history for alcoholism and alcohol consumption were investigated. Twenty adult children of alcoholics (ACOAs) and 20 children of social drinking parents (non-ACOAs) were interviewed in 1991 (mean age 24.2 years). Participants described family functioning while growing up and indices of their alcohol consumption. Family history for alcoholism had a direct association with two aspects of drinking. ACOAs reported more lifetime drinks and tended to report drinking more frequently during high school, as compared to non-ACOAs. ACOAs also reported more parental unpredictability, which in turn was associated with the above drinking indices. Finally, family history for alcoholism had an indirect association with drinking, as unpredictability mediated this relationship. Research and prevention implications are discussed.     

Lateralized cerebral dysfunction in early and late stage alcoholics

The neuroanatomical consequences of chronic alcohol ingestion were investigated using verbal and nonverbal neuropsychological measures known to be sensitive to the integrity of the left and right cerebral hemispheres, respectively. The performances of a group of 15 men alcoholics with a self-reported drinking history of less than 10 years and a group of 15 men alcoholics with a self-reported drinking history of 10 or more years were compared to that of a group of 15 men nonalcoholic controls. A multiple covariate analysis was done prior to analyzing group differences to determine what influence three covariates (age, education and socioeconomic status) had on the group performances. Some of the tests were significantly influenced by age or education and group differences were analyzed with adjustment for the appropriate covariate. Late stage alcoholics were significantly impaired in some tests of both right and left hemisphere functioning relative to controls. The performance of early stage alcoholics fell between that of controls and late stage alcoholics on most measures and differed significantly from either group on only one measure, where early stage alcoholics were superior to late stage alcoholics. Greater duration of alcoholism and higher average daily consumption were significantly related to decreased performance on some neuropsychological tests used.     

Cognitive-perceptual deficit in an alcoholism spectrum disorder

It was hypothesized that alcoholics and antisocial patients would resemble one another with respect to their pattern of performance on three cognitive-perceptual tasks related to frontal lobe functioning. Using a discriminant function analysis, it was found that alcoholics and antisocial patients were both significantly differentiated from psychiatric controls and college students on the basis of their cognitive-perceptual performance. Moreover, as predicted, alcoholics and antisocial patients were themselves indistinguishable. Consistent with the etiological model, these findings held for both younger and older alcoholics. In addition, it was found that cognitive-perceptual deficit among alcoholics was positively related both to the amount of alcohol consumed per drinking occasion and to the experience of arrest by the police. The results point to a psychological affinity between primary alcoholism and antisocial personality and affirm the relevance of prefrontal-type deficits to problems of control and socialization.     

The influence of alcohol on the activation of outcome expectancies: the role of evaluative expectancy activation in drinking behavior

OBJECTIVE: Despite the well-established finding from questionnaire studies that positive expectancies are associated with drinking behavior, there is comparatively little known about the mechanisms through which they may affect drinking behavior. Incentive motivation models suggest that alcohol itself may alter the value of the expected outcomes of drinking. The current study was designed to examine the influence of low-dose alcohol on the activation of alcohol outcome expectancy value. METHOD: Forty-eight hazardous drinkers (34 men) between the ages of 21 and 35 years were recruited from advertisements in local newspapers for a social drinking study. Participants, whose most frequently consumed beverage was beer, were administered a dose of either alcoholic (8.5%) beer, based on gender and weight to reach a blood alcohol concentration of 40 mg/dl, or an equivalent volume of placebo beer. Following an absorption phase, a computerized evaluative priming task was completed in which participants made a series of judgments about the value of positive and negative outcomes following either alcohol or neutral word primes. RESULTS: Those who consumed alcohol made faster evaluative responses to positive relative to negative outcomes, compared with individuals who consumed the placebo beverage. CONCLUSIONS: These findings suggest that moderate doses of alcohol may influence the incentive value of positive relative to negative outcome expectancies. It is suggested that these processes may play a role in patterns of hazardous alcohol use.     

A double-blind, placebo-controlled pilot trial of quetiapine for the treatment of Type A and Type B alcoholism

BACKGROUND: Atypical antipsychotics may be useful in the treatment of alcohol dependence. Human trials suggest that atypical antipsychotics may reduce alcohol craving and consumption, especially among patients with comorbid psychopathology. Therefore, these medications may be more useful for treating more severely affected alcoholics, such as patients with Type B alcoholism. Type B alcoholics are characterized by an early age of onset of problem drinking, high severity of alcohol dependence, increased psychopathology, and treatment-resistance. Quetiapine is an atypical antipsychotic with a favorable side effect profile, and may be a promising medication for the treatment of alcohol dependence, particularly Type B alcoholism. METHODS: Male and female alcoholics (33 Type A and 28 Type B) were included in a 12-week, double-blind, placebo-controlled trial. After detoxification, patients were randomized to receive quetiapine (n = 29), 400 mg/d at bedtime, or placebo (n = 32). The primary outcome measure was the quantity and frequency of alcohol consumption, measured by the timeline follow back. RESULTS: Forty-seven patients (77%) completed the trial, with no significant between-group differences in treatment retention. Nine quetiapine-treated patients (31%) maintained complete abstinence compared with 2 placebo-treated patients (6%) (chi(2) = 6.3, P = 0.012). There was a significant interaction between quetiapine and alcoholic subtype. As predicted, quetiapine- versus placebo-treated Type B alcoholics had significantly fewer days of drinking and fewer days of heavy drinking. Alcohol craving was also significantly reduced in quetiapine-treated compared with placebo-treated Type B alcoholics. Among Type A alcoholics, quetiapine provided no advantage over placebo in improving drinking outcomes. CONCLUSIONS: Quetiapine may be effective for the treatment of alcohol dependence, particularly in the more complicated Type B, early-onset alcoholics.     

The drinking patterns of American and Polish university students: a cross-national study

A study of 3375 American and 1408 Polish university students was accomplished to test the hypotheses that cultural differences influence drinking patterns and beverage preferences between countries. Using the same questionnaire in both samples, the results revealed that significantly (P less than 0.001) more drinks per week were consumed by both Polish male (24.9) and female (15.2) students compared to American male (15.0) and female (7.6) students. Significantly (P less than 0.001) more wine was consumed by Polish (8.7) compared to the American (0.8) students. American female students consumed more beer than Polish female students. There was no difference between beer and spirits consumption between American and Polish males and Polish students in latter school years consumed more alcohol compared to students in the first years of school. It was concluded that the samples of students in this study reflected their cultures in terms of drinking patterns and beverage preference.     

CONTROLLED COMPARISON OF EFFECTS OF EXERCISE AND ALCOHOL ON BLOOD PRESSURE AND SERUM HIGH DENSITY LIPOPROTEIN CHOLESTEROL IN SEDENTARY MALES

1. Seventy-two sedentary male drinkers, aged 20-45 years, and with mean blood pressure (BP) at entry of 132 +/- 1.2/73 +/- 0.9 mmHg, completed a 4 week study during which they were assigned randomly to either drink a low alcohol beer (effectively reducing their weekly alcohol intake from 481 +/- 47 mL to 52 +/- 5 mL) or to continue their normal drinking habits. 2. Within these two groups subjects were further assigned to either a moderate exercise programme of three 30 min sessions per week of stationary cycling at 60-70% maximum workload or to a control light exercise programme where they pedalled against zero or minimal resistance. 3. Both alcohol restriction and moderate exercise were associated with mean falls in bodyweight of 0.5 kg. After adjustment for bodyweight a significant main effect of alcohol restriction on systolic BP (-4.1 +/- 1.7 mmHg, P less than 0.05) and diastolic BP (-1.6 +/- 0.8 mmHg, P = 0.05) was demonstrated. There was no significant main effect of moderate exercise on systolic or diastolic blood pressure despite a significant improvement in physical fitness (maximal oxygen uptake increasing from 33.2 +/- 0.8 mL/kg per min to 35.5 +/- 0.1 mL/kg per min). 4. Significant falls in high density lipoprotein cholesterol (HDLC) and triglyceride levels seen with alcohol restriction were unaffected by the increase in fitness, the magnitude of the fall being similar in both the moderate and light exercise groups.(ABSTRACT TRUNCATED AT 250 WORDS)     

Transferrin and mitochondrial aspartate aminotransferase in young adult alcoholics

Two recently proposed biochemical markers of alcoholism, namely, quantitation of plasma transferrin variant (Tf5.7) and the ratio of plasma mitochondrial aspartate aminotransferase (m-AspAT) to total AspAT (t-AspAT), were tested for their ability to detect young adult alcoholics. Another commonly used biochemical test, namely, activity of plasma gamma glutamyltransferase (GGT) was included as a comparison. Although mean values of GGT, TF5.7, total transferrin (Tftot), m-AspAT and t-AspAT in alcoholics were significantly higher than those in controls, there were too many overlapping values in each test between alcoholics and controls to render any of these tests suitable as a marker for young adult alcoholics. Depending on cut-off limits, the sensitivity of each test ranged from 0-52% and the specificity ranged from 80-97%. Moreover, the m-AspAT/t-AspAT and Tf5.7/Tftot ratios were not significantly different between alcoholics and controls. A stepwise linear discriminant function analysis of all the variables resulted in a slight increase in classification sensitivity (66%) but a decrease in specificity (77%). The relatively short duration (mean = 5.6 years) of heavy alcohol intake and the time elapsed (mean = 5.8 days) since the alcoholics last consumed alcohol very likely contributed to the low sensitivity. Young adults might also be more resilient with regard to the damaging biochemical effects of ethanol. Abnormal biochemical values might reverse to normal values much more quickly in young adult alcoholics than in those who are older and have more years of alcohol abuse.