苯丙胺类兴奋剂使用障碍者酒精滥用情况调查

目的:了解我国苯丙胺类兴奋剂苯丙胺类兴奋剂(amphetamine-type stimulants,ATS)使用障碍者酒精滥用发生率及相关因素。方法:采用酒精依赖识别测验(The Alcohol Use Disorders Identification Test,AUDIT)对540例ATS使用障碍者进行酒精使用障碍筛查,并收集一般人口学资料、吸毒史、ATS使用情况和酒精使用情况。结果:30.7%的ATS使用障碍患者存在酒精使用障碍。Logistic回归分析发现与"嗨妹/哥"一起使用、通常在家里使用ATS与合并酒精滥用问题相关。结论:ATS使用障碍者合并酒精使用障碍者比例较高,应当关注ATS使用者中的酒精问题的防治工作,以降低多物质滥用危害。     

513例精神分裂症住院患者院前饮酒调查

目的:了解精神分裂症患者住院前的饮酒状况及其酒精使用障碍的共病率。方法:使用自编饮酒调查表、酒精使用障碍筛查量表(AUDIT)对542名住院精神分裂症患者院前的饮酒状况进行调查,根据美国精神障碍诊断与统计手册第5版(DSM-5)酒精使用障碍标准对筛查阳性者(AUDIT≥7)进行诊断。结果:精神分裂症患者男、女及总样本终生饮酒率分别是65.1%、42.2%、55.9%,年饮酒率分别是40.4%、27.2%、35.1%;年饮酒者中男、女及总样本AUDIT阳性率分别是40.3%、12.5%、31.7%。男、女及总样本酒精使用障碍时点共病率分别是9.1%、2.0%、6.2%,男性高于女性(χ~2=10.86,P=0.001)。结论:本地区精神分裂症患者的饮酒率低于普通人群,且合并酒精使用障碍的诊断率低于西方发达国家。     

音乐疗法治疗酒精使用障碍的研究进展

酒精使用障碍是一种常见的物质相关障碍。在非药物治疗方面,常用的干预手段包括动机增强、认知行为疗法、12步疗法等以调整认知及行为为核心的疗法。这类患者存在情绪问题甚至共病心境障碍的比率相当高。这不仅带来诊断治疗上的复杂与困难,还会促使复饮几率大幅增加。音乐治疗作为一种新兴的临床治疗技术,对缓解情绪有较好的效果,开始获得更多关注。本文就国内外对于音乐治疗在酒精使用障碍治疗领域的研究做一综述。     

停止信号任务在酒依赖中的研究进展

<正>目前,频繁的使用酒精或成瘾药物所导致的负面效果已得到全球的广泛关注和重视~([1])。在2012年,全球约有330万人因使用酒精而导致死亡,占全球死亡人数的5.9%。过度使用酒精对个人、家庭及社会产生大量的健康和经济负担,因酒精使用而     

我国酒精相关障碍的流行病学研究进展

酒精作为社会陛成瘾物质，具有高度成瘾性，应用非常普遍，严重影响了人类健康和经济发展。中国是人口大国，占世界人口总数的22％。经济的快速增长增加了酒的消耗量…。全国性或区域性流行病学调查均显示：改革开放后，酒精的生产和消费逐步增加，由酒精所导致的公共卫生问题日趋严重。本文对近年来国内酒精相关障碍的流行病学调查进行综述，了解其流行规律，以减轻酒精相关危害，减少酒精相关负担和成本。     

连续给酒精及重复电休克对小鼠学习记忆的影响

目的观察一次性给酒精、一次性电休克与连续给酒精、重复电休克对小鼠学习记忆的影响。方法以昆明种小鼠为材料,从行为学角度,利用跳台、避暗及水迷宫计算机自动分析处理系统检测小鼠的学习记忆能力。结果一次性给２０％～３０％的酒精及一次性电休克对小鼠的学习记忆能力无影响,４０％的酒精能明显影响小鼠的运动功能;连续２ｗｋ给２０％～３０％的酒精能明显引起小鼠跳台作业中再现障碍、水迷宫中空间辨别障碍及避暗作业中获得障碍,而不影响避暗作业中的记忆再现;重复电休克只引起小鼠明暗觉（避暗）巩固障碍,对空间位置觉（跳台）和空间方位觉（水迷宫）无明显影响。结论连续给酒精及重复电休克造成记忆障碍明显,操作简单,为进一步研究学习记忆机制提供了可靠的行为学依据。     

酒精相关内分泌障碍及肝脏疾病

目的:介绍酒精所致的内分泌障碍及酒精性肝病(ALD)的机制及治疗进展。方法:对近年文献进行复习。结果:本文对酒精对内分泌系统的影响及所致的功能障碍(尤其是对HPA轴、HPT轴及性腺轴的影响)的机制、治疗的进展,酒精性肝病的发生机制、分类及治疗进展进行了介绍。结论:酒精可导致内分泌系统功能障碍及肝功能障碍,酒精引起的障碍早期或可通过戒酒逆转,但晚期病变(如肝硬化)则很难逆转。对晚期患者,除戒酒之外,支持治疗是主要的手段。     

建立啮齿类酒精饮用动物模型的影响因素及研究进展

酒精使用障碍(AUD)是威胁人类健康乃至生命的重要因素之一。世界卫生组织数据显示,全球每年因AUD而死亡的人数约330万。AUD已成为一个全球性公共卫生和社会性问题,但其神经行为学机制并未完全阐明。因此,建立有效和可靠的酒精饮用动物模型对AUD机制的探讨非常重要。本文从动物品系和造模方法等方面进行综述,探讨可能对造模结果造成偏差的相关影响因素,以期对AUD的动物行为学研究有所裨益。     

双硫仑反应76例的临床分析与护理

探讨双硫仑样反应的临朱衣现及护理要点.对2006年5月～2009年12月问我院发生的76例双硫仑反应病人的临床资料及护理情况结合文献进行回顾性分析.76例患者中使用头孢类杭生素65例,其他药物11例;摄入酒精途径包括饮酒、使用含酒精药物;用药与酒精摄入的时间间隔1～27d;经积机治疗及完善的护理,均恢复良好,无1例死亡.应加强对患者进行相关知识的健康教育,避免在使用头孢菌素类杭生素及相关药物前后因饮酒或使用含乙醉的药物、食品时发生双硫仑样反应.同时建议用头孢类及相关药物一月内避免酒精摄入.对发生双硫仑反应的老年人在临来护理上应予特别关注.     

552例男性甲基苯丙胺依赖者DSM-Ⅳ轴Ⅰ障碍的共病情况

目的:探究男性甲基苯丙胺依赖者DSM-IV轴Ⅰ障碍的时点患病率与终身患病率。方法:应用自制的一般人口学资料调查表、吸毒相关因素调查表与DSM-Ⅳ-TR轴I障碍定式临床检查病人版,对来自湖南省三家戒毒机构的552名男性甲基苯丙胺依赖者进行调查。结果:非物质障碍的时点患病率为10.87%,终身病率为20.47%。其中时点患病情况:以共病物质所致精神障碍(35.5%)最为普遍。终身患病情况:以共病物质所致精神障碍(36.59%)最为普遍,其次为原发性心境障碍(15.58%),原发性精神障碍(10.69%)及物质所致心境障碍(10.51%)。甲基苯丙胺依赖合并其他物质障碍的时点患病率为27.07%,终身患病率为66.30%。时点患病情况:共病其他物质使用障碍相对较少。终身患病情况:与鸦片类物质使用障碍(36.96%)共病最为普遍,其次为酒精使用障碍(32.25%)及致幻剂使用障碍(30.25%)。以是否共患其他物质使用障碍将被试分组,甲基苯丙胺依赖合并其他物质使用障碍组与仅甲基苯丙胺依赖组相比,物质所致精神障碍的终身患病率(χ2=13.217,P<0.001);原发性心境障碍的终身患病率(χ2=13.217,P<0.001)及物质所致心境障碍的终身患病率(χ2=13.217,P<0.001)更高。结论:男性甲基苯丙胺依赖者共病其他DSM-Ⅳ-TR轴Ⅰ精神障碍诊断情况较为普遍。为了提高治疗效果及预防复吸,应重视其的共病问题。     

Exploration of the Comorbidity of Alcohol Use Disorders and Mental Health Disorders Among Inpatients Presenting to All Hospitals in New South Wales,Australia

ABSTRACT

Alcohol is one of the most commonly used legal psychoactive substances, and its use often coexists with mental health disorders. This study explores the relationships between alcohol use and some common mental health disorders. Admissions to all New South Wales (NSW) hospitals were analyzed. The data were extracted from the NSW Department of Health Inpatient Statistics Data Collection for the period 1 July 2006 to 30 June 2007. Readmissions within 28 days were excluded. Data extraction and analyses were performed by using the SAS program. Chi-square tests and odds ratio were used to measure the association. Of the 1.8 million admissions, associations between alcohol use disorders and mental health disorders were strong (odds ratio 7.8 to 10.7, P < .001). A 33.8% of patients who used alcohol had at least 1 identifiable mental disorder. Higher comorbidity rates were observed for females (39.6%) and for those aged between 30 and 49 years. The most common mental disorders were anxiety disorders, bipolar affective disorders, major depressive disorders, personality disorders, schizophrenia, and severe stress disorders. Comorbidity with one of these mental disorders ranged from 1% to 17.6%, with significant associations (odds ratio 5.6 to 14.1). The average length of stay (ALOS) for alcohol use disorders were 6.4 days and the ALOS for the most common mental health admissions was 11.2 days. This study provides detailed information about the association between alcohol use and mental health disorders and extends our understanding of comorbidity presentations in inpatient admissions.     

Risks of major depressive disorder and anxiety disorders among Thais with alcohol use disorders and illicit drug use: Findings from the 2008 Thai National Mental Health survey

Little is known about the risks of mood and anxiety disorders among Asians with alcohol use disorders and the effect of illicit drug use in this population. All participants from the 2008 Thai National Mental Health survey (N=17,140) were assessed for current major depressive disorder, anxiety disorders, and alcohol use disorders by using the Mini International Neuropsychiatric Interview (MINI) and were interviewed for illicit drug use within one year prior to their assessment. Logistic regression modeling was used to determine (a) whether alcohol use disorders were associated with major depressive disorder and anxiety disorders and (b) whether the use of illicit drugs increased these associations. Sex, age, marital status, region, and educational level were found to be significantly associated with major depressive disorder and anxiety disorders and were taken into account in the regression analysis. Compared with the general population, individuals with alcohol use disorders alone had significantly increased risks of major depressive disorder (OR 2.49, 95%CI 1.76-3.53 in men and OR 4.09, 95%CI 2.31-7.26 in women) and anxiety disorders (OR 2.21, 95%CI 1.46-3.36 in men and OR 4.34, 95%CI 2.35-8.03 in women). The risks became higher among individuals with both alcohol use disorders and illicit drug use (OR 3.62, 95% CI 1.64-8.01 in men and OR 11.53, 95%CI 1.32-100.65 in women for major depressive disorder, and OR 3.20, 95%CI 1.36-7.51 in men and OR 13.10, 95%CI 1.48-115.60 in women for anxiety disorders). In conclusion, alcohol use disorders were significantly associated with major depressive disorder and anxiety disorders. Illicit drug use was an important factor in increasing these associations, especially in women. Screening for depression, anxiety, and illicit drug use should be done in individuals with alcohol use disorders.     

Alcohol Use Disorders Among Afghan Migrants in Germany

ABSTRACT

Little is known about the effect of acculturation on patterns of alcohol use for migrants from Islamic countries. In a field study of Afghan migrants to Germany, participants who drink alcohol were screened with respect to alcohol use problems and then interviewed concerning patterns of use, mental health, and sociodemographic variables. Snowball sampling was used until 50 Afghan migrants with alcohol use disorders could be interviewed. A significant correlation was found between acculturation stress and mental distress, as well as between mental distress and severity of alcohol use. These correlations did not differ with respect to whether alcohol had been used prior to migration. The findings support the hypothesis of the effect of acculturation on problematic alcohol use. Acculturation needs to be focused on in the treatment of alcohol use disorders.     

Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions

BACKGROUND: To date, there have been no published data on 12-month comorbidity of DSM-IV alcohol and drug use disorders in the general U.S. population. The purposes of the present study were to examine the prevalence and comorbidity of alcohol and specific drug use disorders, and to identify sociodemographic and psychopathologic correlates and treatment seeking among three groups of respondents: (1) those with alcohol use disorders only; (2) those with drug use disorders only; (3) those with comorbid alcohol and drug use disorders. METHODS: Information on 12-month alcohol and specific drug use disorders in the United States was derived from face-to-face interviews in the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC: n = 43,093). RESULTS: Prevalences were 7.35% for alcohol use disorders only, 0.90% for drug use disorder only and 1.10% for comorbid alcohol and drug use disorders. Sociodemographic and psychopathologic correlates of these three groups were quite different, with the drug use disorder and comorbid groups significantly more likely to be young, male, never married and of lower socioeconomic status than the alcohol use disorder only group. Associations between current alcohol use disorders and 25 specific drug use disorders were generally positive and statistically significant. The 12-month prevalence of treatment seeking significantly increased from 6.06% for those with an alcohol use disorder only to 15.63% for those with a drug use disorder only, and to 21.76% for those with comorbid alcohol and drug use disorders. CONCLUSIONS: This study provides detailed data on the homotypic comorbidity of alcohol use disorders and 25 different drug use disorders and confirms the high levels of association seen in previous studies based on lifetime measures. Implications of this study are discussed in terms of integrating alcohol and drug treatment services and refining prevention and intervention efforts.     

Reasons for substance use among people with mental disorders

Background

Comorbidity of mental disorders and substance use continues to be a major problem. To inform the development of more effective interventions for these co-existing disorders, this paper aimed to determine if there are clear variations in the reasons for tobacco, alcohol or cannabis use across people with different mental disorders.

Methods

Data from five randomized controlled trials on co-existing disorders that measured reasons for tobacco, alcohol or cannabis use using the Drug Use Motives Questionnaire, Reasons for Smoking Questionnaire or via free response are reported and combined. Two studies involved participants with depression, two involved participants with a psychotic disorder and one involved participants with a range of mental disorders. A series of logistic regressions were conducted to examine differences in reasons for tobacco, alcohol or cannabis use and to compare these reasons between people with psychotic disorders or depression.

Results

Participants had a mean age of 38 (SD = 12) and just over half (60%) were male. Forty-six percent of participants had a psychotic disorder and 54% experienced depression. Data from 976 participants across the five studies were included in the analyses. Tobacco and alcohol were primarily used to cope, while cannabis was primarily used for pleasure. People with psychotic disorders were more likely than people with depression to use tobacco for coping, pleasure and illness motives. People with depression, in contrast, were more likely to use alcohol for these reasons and social reasons.

Conclusions

It may be important to tailor interventions for co-existing mental disorders and substance use by substance type and type of mental disorder. For example, interventions might be improved by including alternative coping strategies to tobacco and/or alcohol use, by addressing the social role of alcohol and by helping people with mental disorders using cannabis to gain pleasure from their lives in other ways.     

Psychopathology in adolescent alcohol abuse and dependence

Adolescents who abuse or are dependent on alcohol often have coexisting mental disorders. These disorders may both precipitate alcohol use disorders and result from them. In addition, both types of disorders may arise independently in adolescents at high risk. Mental disorders that commonly co-occur with alcohol use disorders in adolescents include antisocial disorders, mood disorders, and anxiety disorders. Treatment programs for adolescents with alcohol use disorders should seek not only to eliminate alcohol and other drug use but also to improve the symptoms of other mental disorders.     

Alcohol use disorders in adolescents: epidemiology,diagnosis, psychosocial interventions,and pharmacological treatment

Alcohol (ethanol) abuse and dependence are the most common substance use disorders among adolescents. Binge drinking occurs in up to one-third of adolescents, and alcohol use disorders occur in about 6% of this age group. Adolescents with alcohol use disorders also typically have problems with other substances and comorbid mental disorders. Validated measures are available for the clinical detection and diagnosis of adolescent alcohol use disorders and related problems. Psychosocial interventions promoting abstinence are the most common treatments for alcohol use disorders, with empirical support particularly strong for family-based approaches. Pharmacological interventions may diminish the effects of alcohol withdrawal, prevent a return to alcohol consumption, or treat comorbid mental disorders. In this population, pharmacological interventions require further investigation and, where indicated, are generally considered to be supplementary to psychosocial approaches.     

Factors affecting the use of mental health services in people with alcohol disorders

In a preliminary analysis of data from a community survey of psychiatric disorders in urban Christchurch, 157 of the 1018 adults interviewed met diagnostic criteria for alcohol abuse and/or dependence. The subjects who met the criteria for alcohol abuse and/or dependence were more likely to have used mental health services than the population at large, although 39% of those with an alcohol disorder had never used any form of mental health service. We examined the impact of severity of alcohol disorder, duration of disorder and gender on the use of services among those with an alcohol disorder. Duration of disorder was not related to use of mental health services. Women are more likely than men to use these services. However, the most important finding was that those with the most severe disorders were most likely to have used mental health services.     

A cross-national study on Mexico-US migration, substance use and substance use disorders

Background

Epidemiologic research has consistently found lower prevalence of alcohol and drug use disorders among Hispanic immigrants to the US than among US-born Hispanics. Recent research has begun to examine how this change occurs in the process of assimilation in the US. We aimed to study immigration, US nativity, and return migration as risk factors for alcohol and drug use among people of Mexican origin in both the US and Mexico.

Methods

Data come from nationally representative surveys in the United States (2001-2003; n = 1208) and Mexico (2001-2002; n = 5782). We used discrete time event history models to account for time-varying and time-invariant characteristics.

Results

We found no evidence that current Mexican immigrants in the US have higher risk for alcohol or alcohol use disorders than Mexicans living in Mexico, but current immigrants were at higher risk for drug use and drug use disorders. Current Mexican immigrants were at lower risk for drug use and drug disorders than US-born Mexican-Americans. US nativity, regardless of parent nativity, is the main factor associated with increasing use of alcohol and drugs. Among families of migrants and among return migrants we found increased risk for alcohol use, drug use and alcohol and drug use disorders. Evidence of selective migration and return of immigrants with disorders was found regarding alcohol use disorders only.

Conclusions

Research efforts that combine populations from sending and receiving countries are needed. This effort will require much more complex research designs that will call for true international collaboration.     

After the drinking stops: completed suicide in individuals with remitted alcohol use disorders

A substantial minority of suicide victims have remitted alcohol use disorders. The authors hypothesized that psychiatric disorders are likely to be present in this group to create the necessary conditions for suicide. They compared suicide victims with active alcohol use disorders and those with remitted alcohol use disorders. Using data on a community sample of suicide victims (N=141), it was determined that 39% (N=55) had a history of alcohol misuse. These subjects were categorized by alcohol use disorder status (remitted versus active) and by age (<50, > or =50), creating four cells: younger remitted (N=8), older remitted (N=9), younger active (N=22), and older active (N=16) alcohol misusers. Results comparing proportions of DSM-III-R Axis I disorders in the four groups indicated that suicide victims with remitted alcohol use disorders were predominantly younger victims with psychotic disorders or older victims with major depression. These findings have implications for identifying those at risk for suicide even after the cessation of alcohol misuse. Case examples of suicide victims with remitted alcohol use disorders-a younger woman victim with a psychotic disorder and an older man with major depression-are presented.