Effectiveness of a national ‘Minnesota Model’ based residential treatment programme for alcohol dependence in Ireland: outcomes and predictors of outcome

2017 ◽  
Vol 35 (1) ◽  
pp. 33-41 ◽  
Author(s):  
C. Gallagher ◽  
Z. Radmall ◽  
C. O’Gara ◽  
T. Burke
Keyword(s):  
Alcohol Dependence ◽  
Psychosocial Functioning ◽  
Inpatient Treatment ◽  
Treatment Effectiveness ◽  
Outcome Data ◽  
Alcohol Problems ◽  
Treatment Programme ◽  
Treatment Entry ◽  
Minnesota Model

ObjectivesThe aims of this study were (a) to examine the effectiveness of an inpatient treatment programme for alcohol dependence based on the ‘Minnesota Model’ and (b) to examine potential predictors of outcomes from such treatment.MethodsDemographics and data relating to psychosocial functioning of a group of individuals who commenced treatment for alcohol dependence were gathered at the point of treatment entry. These individuals were then followed up 6 months after they were to complete their inpatient treatment to establish their alcohol-related outcomes. Outcomes from treatment were identified as an index of treatment effectiveness and the outcome data were analysed to determine whether any of the baseline variables could be used to predict outcomes from treatment.ResultsOf those who were contacted at 6-month follow-up, 81.5% had a ‘good outcome’. This represented 66.7% of the total group who participated in the study. The only variable that was found to predict outcomes at 6-month follow-up was severity of alcohol dependence at treatment entry, with more severe alcohol problems associated with poorer outcomes.ConclusionsThis study provides evidence of the potential for a Minnesota-based treatment programme to be effective in helping people with alcohol dependence to reduce the amount of alcohol they consume and sustain this reduction beyond the treatment period.

scholarly journals Genetic differences in alcohol sensitivity and the inheritance of alcoholism risk

1999 ◽  
Vol 29 (5) ◽  
pp. 1069-1081 ◽  
Author(s):  
A. C. HEATH ◽  
P. A. F. MADDEN ◽  
K. K. BUCHOLZ ◽  
S. H. DINWIDDIE ◽  
W. S. SLUTSKE ◽  
...  
Keyword(s):  
Alcohol Dependence ◽  
Alcohol Problems ◽  
Body Sway ◽  
Alcohol Sensitivity ◽  
Parental Alcoholism ◽  
Drinking Habits ◽  
Age Cohort ◽  
History Of ◽  
Alcoholism Risk

Background. Substantial evidence exists for an important genetic contribution to alcohol dependence risk in women and men. It has been suggested that genetically determined differences in alcohol sensitivity may represent one pathway by which an increase in alcohol dependence risk occurs.Methods. Telephone interview follow-up data were obtained on twins from male, female and unlike-sex twin pairs who had participated in an alcohol challenge study in 1979–81, as well as other pairs from the same Australian twin panel surveyed by mail in 1980–82.Results. At follow-up, alcohol challenge men did not differ from other male twins from the same age cohort on measures of lifetime psychopathology or drinking habits; but alcohol challenge women were on average heavier drinkers than other women. Acomposite alcohol sensitivity measure, combining subjective intoxication and increase in body-sway after alcohol challenge in 1979–81, exhibited high heritability (60%). Parental alcoholism history was weakly associated with decreased alcohol sensitivity in women, but not after adjustment for baseline drinking history, or in men. High alcohol sensitivity in men was associated with substantially reduced alcohol dependence risk (OR=0·05, 95% CI 0·01–0·39). Furthermore, significantly decreased (i.e. low) alcohol sensitivity was observed in non-alcoholic males whose MZ co-twin had a history of alcohol dependence, compared to other non-alcoholics. These associations remained significant in conservative analyses that controlled for respondents' alcohol consumption levels and alcohol problems in 1979–81.Conclusions. Men (but not women) at increased genetic risk of alcohol dependence (assessed by MZ co-twin's history of alcohol dependence) exhibited reduced alcohol sensitivity. Associations with parental alcoholism were inconsistent.

Anxiety and depression among patients with alcohol dependence: co-morbid or substance-related problems?

2017 ◽  
Vol 35 (2) ◽  
pp. 121-126 ◽  
Author(s):  
C. Gallagher ◽  
Z. Radmall ◽  
C. O’Gara ◽  
T. Burke
Keyword(s):  
Alcohol Dependence ◽  
Psychiatric Symptoms ◽  
Alcohol Problems ◽  
Alcohol Problem ◽  
Anxiety And Depression ◽  
Treatment Seeking ◽  
Co Morbidity ◽  
Treatment Entry ◽  
The Stability ◽  
Morbid Conditions

ObjectivesThere are conflicting reports on the levels of anxiety and depression in individuals with alcohol problems and whether these conditions are substance-related or independent of the alcohol problem. The aim of this study was to characterise rates of co-morbid psychiatric symptoms among a group of individuals commencing treatment for alcohol dependence, and to examine the stability of these symptoms following treatment of the alcohol problem.MethodsSymptoms of anxiety and depression were examined in a group of individuals (n=93) undergoing residential treatment for alcohol dependence. Symptoms were measured at treatment entry and again at treatment completion using the Beck Anxiety Inventory and the Beck Depression Inventory – II.ResultsHigh levels of anxiety and depressive symptoms were reported at treatment entry, but on completion of treatment (28 days later) the majority of participants were no longer reporting symptoms suggestive of a possible co-morbid condition.ConclusionsThe significant change in rates of reported symptoms following completion of treatment suggests that a large proportion of symptoms reported at treatment entry were substance related. Diagnosing co-morbid conditions is best left until after a period of abstinence during which the alcohol problem has been treated. Assessing for co-morbidity at time of treatment seeking is likely to result in inappropriate co-morbid diagnoses being made and inappropriate or unnecessary treatments being prescribed for such individuals.

scholarly journals Gratitude while Drinking, Gratitude while Recovering

2019 ◽  
Vol 1 (3) ◽  
pp. 1-15 ◽  
Author(s):  
Amy R. Krentzman ◽  
Michael T. M. Finn
Keyword(s):  
Alcohol Dependence ◽  
Alcoholics Anonymous ◽  
Psychosocial Functioning ◽  
Psychiatric Symptoms ◽  
Clinical Factors ◽  
Clinical Indicators ◽  
Problematic Drinking ◽  
Addiction Severity ◽  
Trait Gratitude

Background. For decades researchers have debated whether those diagnosed with alcohol use disorders can return to non-problematic drinking. Now, recovery researchers are measuring aspects of wellbeing in addition to aspects of pathology, producing surprising findings that have added to the debate. Recent studies show that some who continue to drink endorse high levels of psychosocial functioning. Objectives. Employ trait gratitude to answer the following questions: how do individuals who continue to drink but endorse high gratitude at follow-up differ from peers at baseline? Does trait gratitude correlate differently with demographic, psychosocial, and clinical factors for abstinent members of Alcoholics Anonymous (AA) versus drinking non-AAs? Methods. 275 individuals with alcohol dependence were assessed for trait gratitude at 2.5-3 year follow-up in a naturalistic, longitudinal study. Psychosocial and clinical indicators were assessed at baseline and follow-up. Results. Drinkers who endorsed high gratitude had higher socioeconomic status, greater levels of positive spirituality, more stable personality indicators, less addiction severity, fewer negative life events, and fewer psychiatric symptoms than their peers at baseline. For actively drinking non-AAs, trait gratitude correlated differently, and positively, with years of education, income, and purpose in life compared with sober AAs. For AA members, gratitude correlated positively with AA involvement and length of sobriety. Discussion. A subset of drinkers report doing relatively well despite meeting criteria for alcohol dependence. Trait gratitude correlated differently with other constructs for AAs versus non-AAs, indicating that gratitude for recovery might be contextually sensitive, operating differently within and without the structure of AA.

Symptoms of Alcohol Dependence Predict Suicide Ideation Among Alaskan Undergraduates

Crisis ◽  
2016 ◽  
Vol 37 (3) ◽  
pp. 232-235 ◽  
Author(s):  
Christopher R. DeCou ◽  
Monica C. Skewes
Keyword(s):  
Depressive Symptoms ◽  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Suicide Ideation ◽  
Alcohol Problems ◽  
Future Research ◽  
Causal Mechanism ◽  
Students At Risk ◽  
The Relationship ◽  
Alcohol Related Problems

Abstract. Background: Previous research has demonstrated an association between alcohol-related problems and suicidal ideation (SI). Aims: The present study evaluated, simultaneously, alcohol consequences and symptoms of alcohol dependence as predictors of SI after adjusting for depressive symptoms and alcohol consumption. Method: A sample of 298 Alaskan undergraduates completed survey measures, including the Young Adult Alcohol Consequences Questionnaire, the Short Alcohol Dependence Data Questionnaire, and the Beck Depression Inventory – II. The association between alcohol problems and SI status was evaluated using sequential logistic regression. Results: Symptoms of alcohol dependence (OR = 1.88, p < .05), but not alcohol-related consequences (OR = 1.01, p = .95), emerged as an independent predictor of SI status above and beyond depressive symptoms (OR = 2.39, p < .001) and alcohol consumption (OR = 1.08, p = .39). Conclusion: Alcohol dependence symptoms represented a unique risk for SI relative to alcohol-related consequences and alcohol consumption. Future research should examine the causal mechanism behind the relationship between alcohol dependence and suicidality among university students. Assessing the presence of dependence symptoms may improve the accuracy of identifying students at risk of SI.

Profiles of Psychosocial and Clinical Functioning in Adolescence and Risk for Later Depression

2019 ◽  
Author(s):  
Thomas M Olino ◽  
Daniel Klein ◽  
John Seeley
Keyword(s):  
Psychosocial Functioning ◽  
Adolescent Depression ◽  
Depressive Disorders ◽  
Self Report ◽  
Initial Assessment ◽  
Predictive Utility ◽  
Regression Methods ◽  
History Of ◽  
History Of Depression

Background: Most studies examining predictors of onset of depression focus on variable centered regression methods that focus on effects of multiple predictors. In contrast, person-centered approaches develop profiles of factors and these profiles can be examined as predictors of onset. Here, we developed profiles of adolescent psychosocial and clinical functioning among adolescents without a history of major depression. Methods: Data come from a subsample of participants from the Oregon Adolescent Depression Project who completed self-report measures of functioning in adolescence and completed diagnostic and self-report measures at follow-up assessments up to approximately 15 years after baseline. Results: We identified four profiles of psychosocial and clinical functioning: Thriving; Average Functioning; Externalizing Vulnerability and Family Stress; and Internalizing Vulnerability at the baseline assessment of participants without a history of depression at the initial assessment in mid- adolescence. Classes differed in the likelihood of onset and course of depressive disorders, experience of later anxiety and substance use disorders, and psychosocial functioning in adulthood. Moreover, the predictive utility of these classes was maintained when controlling for multiple other established risk factors for depressive disorders. Conclusions: This work highlights the utility of examining multiple factors simultaneously to understand risk for depression.

Improvement in psychological wellbeing among adolescents with a substance use disorder attending an outpatient treatment programme

2021 ◽  
pp. 1-8
Author(s):  
N.M. Gamage ◽  
C. Darker ◽  
B.P. Smyth
Keyword(s):  
Substance Use ◽  
Psychological Symptoms ◽  
Significant Proportion ◽  
Cannabis Use ◽  
Psychological Wellbeing ◽  
Substance Use Treatment ◽  
Disruptive Behaviour ◽  
Treatment Programme ◽  
The Impact

Objectives: Adolescents with substance use disorders (SUDs) exhibit high rates of comorbid psychological problems. This study aimed to examine the impact of an outpatient substance use treatment programme upon the psychological wellbeing of adolescents. Methods: A prospective study was carried out examining psychological symptoms in a group of adolescents attending the Youth Drug and Alcohol (YoDA) Addiction Service in Dublin. Participants were treated with evidenced based psychological models such as cognitive behavioural therapy, motivational interviewing and systemic family therapy. The Becks Youth Inventory was utilised to assess psychological symptoms at treatment entry and repeated three months later at follow up. Results: Among 36 adolescents who were included in this study, poly-substance misuse was the norm. Almost three-quarter had a cannabis use disorder (CUD). There were significant reductions in mean subscale scores of depression (56.0 to 50.8, p = 0.003), anger (55.2 to 49.5, p < 0.001) and disruptive behaviour (61.6 to 56.5, p = 0.002) at follow up. Although there wasn’t a statistically significant reduction in mean scores for anxiety, we observed a significant proportion of participants (p = 0.008) improving and moving out of a moderate to severe symptom range when examined by category. This was also the case for self-concept (p = 0.04). Furthermore this study revealed a positive correlation between the reduction in days of cannabis use and reduction in depressive scores (Pearson correlation 0.49, p = 0.01) among those with a CUD. Conclusion: The findings indicate that substance use treatment for adolescents is associated with important psychological and behavioural improvements.

Outcomes after Emergency Admission with a Diabetic Foot Attack Indicate a High Rate of Healing and Limb Salvage But Increased Mortality: 18-Month Follow-up Study

2020 ◽  
Author(s):  
Erika Vainieri ◽  
Raju Ahluwalia ◽  
Hani Slim ◽  
Daina Walton ◽  
Chris Manu ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Diabetic Foot ◽  
Emergency Admission ◽  
Arterial Disease ◽  
Major Amputation ◽  
Outcome Data ◽  
High Rate ◽  
Free Survival ◽  
Peripheral Arterial

Abstract Aim The diabetic foot attack (DFA) is perhaps the most devastating form of diabetic foot infection, presenting with rapidly progressive skin and tissue necrosis, threatening both limb and life. However, clinical outcome data in this specific group of patients are not available. Methods Analysis of 106 consecutive patients who underwent emergency hospitalisation for DFA (TEXAS Grade 3B or 3D and Infectious Diseases Society of America (IDSA) Class 4 criteria). Outcomes evaluated were: 1) Healing 2) major amputation 3) death 4) not healed. The first outcome reached in one of these four categories over the follow-up period (18.4±3.6 months) was considered. We also estimated amputation free survival. Results Overall, 57.5% (n=61) healed, 5.6% (n=6) underwent major amputation, 23.5% (n=25) died without healing and 13.2% (n=14) were alive without healing. Predictive factors associated with outcomes were: Healing (age<60, p=0.0017; no Peripheral arterial disease (PAD) p= 0.002; not on dialysis p=0.006); major amputation (CRP>100 mg/L, p=0.001; gram+ve organisms, p=0.0013; dialysis, p= 0.001), and for death (age>60, p= 0.0001; gram+ve organisms p=0.004; presence of PAD, p=0.0032; CRP, p=0.034). The major amputation free survival was 71% during the first 12 months from admission, however it had reduced to 55.4% by the end of the follow-up period. Conclusions In a unique population of hospitalised individuals with DFA, we report excellent healing and limb salvage rates using a dedicated protocol in a multidisciplinary setting. An additional novel finding was the concerning observation that such an admission was associated with high 18-month mortality, almost all of which was after discharge from hospital.

scholarly journals Association between post-balloon angioplasty dissection and primary patency in complex femoropopliteal artery disease: 2-year clinical outcomes of the AcoArt I trial

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110065
Author(s):  
Hao Ren ◽  
Jie Liu ◽  
Jiwei Zhang ◽  
Baixi Zhuang ◽  
Weiguo Fu ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Cox Regression ◽  
Target Lesion ◽  
Transluminal Angioplasty ◽  
Outcome Data ◽  
Primary Patency ◽  
Cox Regression Analysis ◽  
Femoropopliteal Artery ◽  
Artery Disease

Objective To assess the association between post-balloon angioplasty dissection and the mid-term results of the AcoArt I trial evaluating complex femoropopliteal artery disease. Methods The outcome data for 144 patients from the AcoArt 1 trial were reanalysed. These patients were randomly divided into percutaneous transluminal angioplasty (PTA) and drug-coated balloons (DCB) groups. The primary endpoint was the primary patency (PP) rate and clinically-driven target lesion revascularisation at 24 months. Results After 24 months of follow-up, the PP rate of dissection cases in the PTA group was lower vs non-dissection cases. In patients receiving a bailout stent for dissection, the PP rate in the PTA group was lower vs the DCB group. Cox regression analysis showed that dissection decreased the PP rate; mild dissection reduced the PP rate as follows: 52%, PTA group and 19%, DCB group. With severe dissection, the PP rate reduction was as follows: 75%, PTA group and 73%, DCB group. Conclusions The mid-term follow-up showed that post-balloon angioplasty dissection reduced the PP rate in the PTA group but not in the DCB group. Additionally, in patients receiving a bailout stent for dissection, the DCB group had a better PP rate than the PTA group.

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