Psychopathology in offspring from families of alcohol dependent female probands: A prospective study

Background

Despite the importance of understanding the long-term outcome for children of alcohol dependent (AD) women, the available literature is largely based on offspring of AD fathers and few have utilized prospective designs that include child, adolescent and young adult assessments. Multiplex AD families in which multiple cases of AD are present provide an ideal setting for understanding developmental variants of the adult phenotype.

Method

Offspring from multiplex AD families identified through the mother or control families were evaluated multiple times during childhood and followed to young adulthood. Familial risk status and the presence of specific child/adolescent disorders were used as predictors of substance use disorder outcome by young adulthood.

Results

Offspring who were members of maternal multiplex families had elevated rates of child and young adulthood disorders. High risk offspring of alcohol dependent women were at increased risk for externalizing (Conduct Disorder and ADHD) and internalizing disorders (Major Depressive Disorder (MDD) and Anxiety Disorders). By young adulthood, offspring from these multiplex families had significantly greater odds of developing alcohol abuse or dependence (odds ratio [OR] = 3.63 [CI 1.36-9.64]) and drug abuse or dependence (OR = 4.23 [CI 1.73-10.32]). The prospective design of the study revealed that specific childhood disorders (Conduct Disorder, ADHD, MDD) increased the odds of subsequent development of substance use disorder (SUD).

Conclusions

Multiplex familial risk for alcohol dependence is a significant predictor of substance use disorders by young adulthood. Familial risk and an earlier childhood disorder may set the stage for later development of SUD.     

Substance use and quality of life over 12 months among buprenorphine maintenance-treated and methadone maintenance-treated heroin-addicted patients

The purpose of this study was to investigate the effects of methadone treatment and buprenorphine treatment on retention in treatment, urine drug testing results, psychiatric status, social adjustment, and quality of life among patients involved in long-term treatment with the cited medications. Two hundred thirteen patients (106 on buprenorphine treatment and 107 on methadone treatment) were enrolled in this open study at the 3rd month of their treatment and followed up until the 12th month; those who left the program before the end of the 3rd month of their treatment were not included in the study sample. The results of this study show statistically significant improvements in opioid use, psychiatric status, and quality of life between the 3rd and 12th months for both medications. This study suggests the long-term efficacy of methadone treatment and buprenorphine treatment on symptoms of opioid addiction and quality of life.     

Association between auditory P300, psychopathology,and memory function in drug-naïve schizophrenia

The aim of this study was to explore memory deficits and psychopathology and their relationships with P300 in drug-naïve patients with schizophrenia. The Positive and Negative Syndrome Scale (PANSS) and the Wechsler Memory Scale—Revised were administered. Auditory event-related potentials elicited by an oddball paradigm were obtained. After controlling for age, sex, the results showed a statistically significant negative correlation between the total PANSS score and P300 amplitude at the parietal position (r = ?0.66, p < 0.05). Moreover, visual memory was significantly positively correlated with P300 amplitude at the parietal position (r = 0.67, p < 0.05). After controlling for the duration of illness, the above correlations remained statistically significant. The correlation between P300 and the severity of psychopathology was reconfirmed in drug-naïve patients with schizophrenia. A possible contribution of memory decompensation in P300 among drug-naïve patients with schizophrenia may be considered, and the compensatory or Default Model Network might be a possible explanation of this association.     

Levels of aggressiveness are higher among alcohol-related suicides: Results from a psychological autopsy study

Suicide is one of the major causes of deaths worldwide. Several studies have showed that alcohol use disorders (AUD) are associated with suicide ideation, suicide attempts, and suicide completion. The majority of the theoretical conceptualization and the bulk of evidence on suicidal behavior and AUD are based on investigations of nonfatal cases because data on nonfatal suicidal behaviors are more readily available. This study aims to explore demographic, clinical, and behavioral dimensions in a large sample of alcohol-related suicides compared to an age-gender matched sample of non-AUD suicides to identify specific factors associated with AUD suicides. We conducted a psychological autopsy study with 158 pairs of AUD and non-AUD suicides. Findings showed that AUD suicides have lower educational level, more biological children and were more likely to be heavy smokers (OR = 3.32). Cases were more likely to have family history of alcohol (OR = 1.73) and drug abuse (OR = 3.61). Subjects had similar prevalences of depressive disorders, anxiety disorders or psychotic disorders. AUD suicides were more likely to meet criteria for current cocaine abuse/dependence (OR = 6.64). With respect to personality disorders, AUD suicides presented higher prevalence of Antisocial Personality Disorder (OR = 4.68), and were less likely to meet criteria for Avoidant (OR = 0.26) and Obsessive-Compulsive Personality Disorders (OR = 0.35). Impulsivity scores were higher in AUD suicides (p = 0.18), as well as aggression scores (p < 0.001). Results form the conditional logistic regression models showed that cocaine abuse/dependence (OR = 4.20) and Antisocial Personality Disorder (OR = 6.24) were associated with AUD suicide. After controlling for impulsive-aggressive behaviors, levels of aggression were the only psychopathological feature statistically different between AUD and non-AUD suicides (OR = 1.28). In conclusion, higher levels of aggressive behaviors are a specific characteristic of AUD suicides. Apart from substance-related diagnoses, AUD and non-AUD suicides have comparable Axis I psychiatric diagnoses and familial transmission of suicidal behavior.     

Trauma and PTSD in patients with alcohol, drug, or dual dependence: a multi-center study

Background:  We investigated (1) the prevalence of posttraumatic stress disorder (PTSD) in treatment-seeking subjects with substance use dependence (SUD), (2) the association between comorbid PTSD and the severity and course of addiction and psychopathology, and (3) this association in patients with subsyndromal PTSD, and in trauma exposure without PTSD.
Methods:  In this cross-sectional study, 459 subjects in 14 German addiction treatment centers participated with alcohol-dependence (A) in 39.7%, drug-dependence (D) in 33.6%, or both (AD) 26.8%. The diagnostic measures included the International Diagnostic Checklists (IDCL), Posttraumatic Diagnostic Scale (PDS), Addiction Severity Index (ASI), and the Brief Psychiatric Rating Scale (BPRS). Associations between independent characteristics and outcomes were analysed by univariate and multivariate statistics.
Results:  25.3% of the subjects had PTSD confirmed by both IDCL and PDS with higher rates in the AD (34.1%) and D (29.9%) groups compared with group A (15.4%, p  < 0.001). In 22.8%, PTSD was subsyndromal (either IDCL or PDS positive) without significant differences between SUD groups, and 18.3% met PTSD trauma criteria A without PTSD (exposure). After controlling for SUD and gender, trauma subgroups significantly differed regarding the onset of alcohol-related symptoms ( p  < 0.02), numbers of previous admissions ( p  < 0.03), severity of SUD ( p  < 0.001), current craving ( p  < 0.02), and psychopathology ( p  < 0.001). We observed the worst outcome in PTSD, while trauma exposure had no effects.
Conclusions:  The prevalence of PTSD is higher in drug than in alcohol dependence. The more strictly PTSD is diagnosed (by interviewer and questionnaire) the more clearly are associations with characteristics of SUD. PTSD seems to be an independent risk factor for an unfavorable outcome of SUD.     

Psychosocial adjustment after epilepsy surgical treatment

Epilepsy is a matter of interest to several medical specialities: neurology, neurosurgery, pathology, psychiatry, and other fields of knowledge such as psychology and sociology. Although a high prevalence of psychopathological disorders is often reported among epileptic patients who are candidates for neurosurgery, this cannot explain the problems that may be experienced by patients after surgery. Numerous related aspects such as neurological, psychological and sociological factors cause disturbances. This study suggests that systematic psychological and social management might help in the transition from chronic disability to wellness by means of improved adjustment potential.     

Psychosocial Functioning,Personality, and Body Image Following Vertical Banded Gastroplasty

Background In addition to increased risks of morbidity and mortality, extreme obesity is substantially associated with psychosocial problems. Therefore, the ultimate goal of bariatric surgery should not only be reducing weight and counteracting comorbid conditions but also improving psychosocial functioning. In addition to being an important goal of bariatric surgery, enhanced psychosocial functioning may motivate patients to adhere to adequate health behavior to maintain the surgically established weight loss. Methods We evaluated early postoperative psychosocial functioning in several domains over time. Preoperatively as well as 6, 12, and 24 months after vertical banded gastroplasty, 104 patients were psychologically assessed using a semi-structured interview and psychological questionnaires focusing on psychosocial functioning, personality, and body image. Results Over time, we found significant changes in weight: 2 years excess weight loss was 58.6%. In addition, most aspects of psychosocial functioning showed significant improvements over time. However, initial improvements in depressive symptoms, sleeping problems, and neuroticism did not last. With respect to personality features, only short-term changes in self-esteem were found. The most robust improvements were seen in the case of body image. Finally, within the patient group, there was a wide variability in changes. Conclusion Vertical banded gastroplasty not only leads to considerable weight loss but also to significant improvements in psychosocial functioning. However, some improvements waned over time, and successful postoperative functioning did not apply to all patients.