Comorbid mental disorders among the patients with alcohol abuse and dependence in Korea.
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This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence. (+info)
Changes in plasma noradrenaline and serotonin levels and craving during alcohol withdrawal.
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AIMS: Despite substantial preclinical evidence that supports the involvement of noradrenergic (NA) and serotonergic (5-HT) mechanisms in alcohol withdrawal, human data remain inconsistent. We examined whether plasma levels of NA and 5-HT were altered during alcohol withdrawal and whether these measures were related to craving. We also explored whether alterations in NA and 5-HT activity differ between type I and type II alcohol-dependent patients during withdrawal. METHODS: Plasma measurements of NA and 5-HT and assessments of craving were performed longitudinally in 26 Caucasian alcohol-dependent men who were hospitalized for detoxification, at baseline (day 0), and on the 1st, 7th and 14th days of withdrawal. These measures were compared with NA and 5-HT levels obtained in 28 controls. RESULTS: During withdrawal, NA levels declined significantly from day 1 through day 14, whereas 5-HT levels and craving declined significantly from day 0 through day 14. The NA levels on days 0 and 1 of withdrawal were significantly higher than those in controls; however, by day 7 the NA levels were similar to the control values. In contrast, the 5-HT levels on day 0 of withdrawal resembled control values; however, the 5-HT concentrations on days 1, 7 and 14 were significantly lower than those in controls. There were no significant correlations between NA and 5-HT levels or between craving and the biological measures during withdrawal. Type I and type II patients did not differ in NA or 5-HT levels during withdrawal. CONCLUSIONS: These findings indicate that both plasma NA and 5-HT levels change during withdrawal; however, the pattern of change is different for the two measures. Also, while alterations in NA activity appear to normalize by late withdrawal, 5-HT changes seem to be more persistent. Neither craving nor subtypes of alcoholism seem to be related to alterations in NA or 5-HT during withdrawal. (+info)
Selective breeding, quantitative trait locus analysis, and gene arrays identify candidate genes for complex drug-related behaviors.
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Acute functional tolerance to ethanol develops during a single exposure to ethanol; it has been suggested to be a predisposing factor for the development of ethanol dependence. Genetic determinants of acute functional tolerance, as well as of ethanol dependence, have been clearly demonstrated. We describe a novel approach that uses a combination of selective breeding (to segregate genes contributing to the phenotype of interest, i.e., acute functional tolerance to the incoordinating effect of ethanol), quantitative trait locus analysis (to define chromosomal regions associated with acute functional tolerance), and DNA microarray technology (to identify differentially expressed genes in the brains of the selected lines of mice) to identify candidate genes for the complex phenotype of ethanol tolerance. The results indicate the importance of a signal transduction cascade that involves the glutamate receptor delta2 protein, the Ephrin B3 ligand, and the NMDA receptor, as well as a transcriptional regulatory protein that may be induced by activation of the NMDA receptor (zinc finger protein 179) and a protein that can modulate downstream responses to NMDA receptor activation (peroxiredoxin), in mediating acute tolerance to the incoordinating effect of ethanol. (+info)
Alcohol and tobacco use disorders in a general population: short-term and long-term associations from the St. Louis epidemiological catchment area study.
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BACKGROUND: Although research using clinical and convenience samples has shown alcohol use disorders (AUD) to be highly comorbid with tobacco dependence (TD), little work has examined this association prospectively using population-based data. The AUD-TD association was prospectively examined using data from the St. Louis Epidemiological Catchment Area (ECA) Study and its 1-year follow-up as well as from a 16-year follow-up on a subsample of ECA data. METHOD: Respondents were 3004 (2564, 85%, at Wave 2) participants in the St. Louis household ECA sample, including 444 participants at Year 16 follow-up. At baseline, the sample was predominately White (58%; 38% Black), female (60%), and 44.3 years. Past-year AUD and TD were diagnosed at all waves according to DSM-III criteria. RESULTS: AUDs and TDs were cross-sectionally associated at Years 1, 2, and 16. Controlling for demographics, Year 1 TD prospectively predicted Year 2 AUD, and Year 1 AUD prospectively predicted Year 16 TD. We found evidence for prediction of onset and persistence of both AUD and TD at short-term but not long-term follow-up. Prospective findings were reduced and no longer reached significance when concurrent diagnoses at follow-up were included in the regression models. CONCLUSIONS: We observed short-term and long-term associations between AUD and TD. These associations were mediated through concurrent diagnoses with the other substance use disorder. (+info)
Alcohol-related morbidity and mortality.
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Alcohol use is related to a wide variety of negative health outcomes including morbidity, mortality, and disability. Research on alcohol-related morbidity and mortality takes into account the varying effects of overall alcohol consumption and drinking patterns. The results from this epidemiological research indicate that alcohol use increases the risk for many chronic health consequences (e.g., diseases) and acute consequences (e.g., traffic crashes), but a certain pattern of regular light-to-moderate drinking may have beneficial effects on coronary heart disease. Several issues are relevant to the methodology of studies of alcohol-related morbidity and mortality, including the measurement of both alcohol consumption and the outcomes studied as well as study design. Broad summary measures that reflect alcohol's possible effects on morbidity, mortality, and disability may be more useful than measures of any one outcome alone. (+info)
Harmful alcohol use.
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Alcohol misuse can harm people other than the drinker, and can have negative consequences for society as a whole. It is commonly believed to play a role in decreased worker productivity, increased unintentional injuries, aggression and violence against others, and child and spouse abuse. Research findings support the idea that drinking is involved in or associated with many of these social harms, but do not offer evidence that it causes these effects. Methodological flaws characterize much of the research in this area. Use of better design and statistical methodology is necessary in order to clarify the relationship between drinking and the harmful consequences it is believed to cause. (+info)
Intracellular proteolytic systems in alcohol-induced tissue injury.
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The body constantly produces proteins and degrades proteins that are no longer needed or are defective. The process of protein breakdown, called proteolysis, is essential to cell survival. Numerous proteolytic systems exist in mammalian cells, the most important of which are the lysosomes, the ubiquitin-proteasome pathway, and enzymes called calpains. Lysosomes are small cell components that contain specific enzymes (i.e., proteases) which break down proteins. Alcohol interferes with the formation and activity of lysosomes and thus may contribute to protein accumulation in the liver, which can have harmful effects on that organ. In the ubiquitin-proteasome pathway, proteins that are to be degraded are first marked by the addition of ubiquitin molecules and then broken down by large protein complexes called proteasomes. Alcohol impairs this proteolytic system through several mechanisms, possibly leading to inflammation and even cell death. Calpains are proteases that are involved in several physiological processes, including the breakdown of proteins that give cells their shape and stability. In contrast to the lysosomal and ubiquitin-proteasome systems, calpains in brain cells are activated by alcohol, to potentially detrimental effect. (+info)
A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 institute of medicine criteria.
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BACKGROUND: The adverse effects of alcohol on the developing human represent a spectrum of structural anomalies and behavioral and neurocognitive disabilities, most accurately termed fetal alcohol spectrum disorders (FASD). The first descriptions in the modern medical literature of a distinctly recognizable pattern of malformations associated with maternal alcohol abuse were reported in 1968 and 1973. Since that time, substantial progress has been made in developing specific criteria for defining and diagnosing this condition. Two sets of diagnostic criteria are now used most widely for evaluation of children with potential diagnoses in the FASD continuum, ie, the 1996 Institute of Medicine (IOM) criteria and the Washington criteria. Although both approaches have improved the clinical delineation of FASD, both suffer from significant drawbacks in their practical application in pediatric practice. OBJECTIVE: The purpose of this report is to present specific clarifications of the 1996 IOM criteria for the diagnosis of FASD, to facilitate their practical application in clinical pediatric practice. METHODS: A large cohort of children who were prenatally exposed to alcohol were identified, through active case-ascertainment methods, in 6 Native American communities in the United States and 1 community in the Western Cape Province of South Africa. The children and their families underwent standardized multidisciplinary evaluations, including a dysmorphology examination, developmental and neuropsychologic testing, and a structured maternal interview, which gathered data about prenatal drinking practices and other demographic and family information. Data for these subjects were analyzed, and revisions and clarifications of the existing IOM FASD diagnostic categories were formulated on the basis of the results. RESULTS: The revised IOM method defined accurately and completely the spectrum of disabilities among the children in our study. On the basis of this experience, we propose specific diagnostic criteria for fetal alcohol syndrome and partial fetal alcohol syndrome. We also define alcohol-related birth defects and alcohol-related neurodevelopmental disorder from a practical standpoint. CONCLUSIONS: The 1996 IOM criteria remain the most appropriate diagnostic approach for children prenatally exposed to alcohol. The proposed revisions presented here make these criteria applicable in clinical pediatric practice. (+info)