scholarly journals Update on the management of alcohol use disorders

2019 ◽  
Vol 26 (2) ◽  
pp. 82-91
Author(s):  
Julia M. A. Sinclair ◽  
Aimee O'Neill
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Alcohol Use Disorders ◽  
Teachable Moment ◽  
Management Options

SUMMARYAlcohol use disorders (AUD) are common, particularly in patients attending mental health services. Clinicians are often hesitant to explore with patients their relationship with alcohol and the role that it has in their presenting complaint, despite being ideally placed to optimise on a ‘teachable moment’ and initiate treatment, where necessary. This article provides an overview of AUD and their identification and management options.

Cognitive impairment in older people with alcohol use disorders in a UK community mental health service

2016 ◽  
Vol 9 (4) ◽  
pp. 154-158 ◽  
Author(s):  
Rahul Rao
Keyword(s):  
Mental Health ◽  
Cognitive Impairment ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Older People ◽  
Alcohol Use Disorders ◽  
Drinking Behaviour ◽  
Content Type

Purpose The assessment of cognitive impairment in community services for older people remains under-explored. The paper aims to discuss this issue. Design/methodology/approach Cognitive impairment was examined in 25 people aged 65 and over with alcohol use disorders, on the caseload of community mental health services over a six-month period. All subjects assessed using Addenbrooke’s Cognitive Assessment (ACE-III). Findings In total, 76 per cent of the group scored below the cut-off point for likely dementia but only 45 per cent of people scored below the cut-off point for tests of language, compared with 68-84 per cent people in other domains. Research limitations/implications This finding has implications for the detection of alcohol-related brain cognitive impairment in clinical settings. Practical implications Standardised cognitive testing is common within mental health services for older people, but may also have utility within addiction services. Social implications The early detection of alcohol-related cognitive impairment can improve social outcomes in both drinking behaviour and the social consequences of alcohol-related dementia. Originality/value This may be the first published study of cognitive impairment in patients under a mental team for older people with alcohol use disorders and offers some unique findings within this sampling frame.

Utilization of Mental Health Services and Risk of 12-month Problematic Alcohol Use

2007 ◽  
Vol 31 (4) ◽  
pp. 392-401 ◽  
Author(s):  
Galle Encrenaz ◽  
Viviane Kovess-Masfty ◽  
David Sapinho ◽  
Christine Chan Chee ◽  
Antoine Messiah
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Problematic Alcohol ◽  
Problematic Alcohol Use

Dual diagnosis in older drinkers during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rahul Rao ◽  
Christoph Mueller ◽  
Matthew Broadbent
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Opioid Use ◽  
Content Type

Purpose There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use. Design/methodology/approach Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders. Findings In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005). Research limitations/implications The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers. Originality/value A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.

scholarly journals Alcohol use among conflict-affected persons in Ukraine: risk factors, coping and access to mental health services

2019 ◽  
Vol 29 (6) ◽  
pp. 1141-1146
Author(s):  
Anu Ramachandran ◽  
Nino Makhashvili ◽  
Jana Javakhishvili ◽  
Andriy Karachevskyy ◽  
Natalia Kharchenko ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Alcohol Use Disorder ◽  
Utilization Of Health Services ◽  
Negative Coping ◽  
And Coping ◽  
Coping Behaviours

Abstract Background There are approximately 1.5 million internally displaced persons (IDPs) in Ukraine as a result of the conflict in eastern Ukraine. Exposure to violence, forced displacement and increased mental disorders are potential risk-factors for alcohol use disorder (AUD). The aim of this study was to estimate the prevalence of and risk factors for AUD among Ukrainian IDPs and investigate the relationship between AUD, mental health service utilization and coping behaviours. Methods A nation-wide cross-sectional survey of 2203 IDPs was conducted. Data were collected on AUD [using alcohol use disorder identification test (AUDIT)], mental health disorders, utilization of health services and coping behaviours. Multivariable logistic regression was used to identify risk factors for AUD, and to estimate the odds ratios for the association between alcohol use and utilization of health services and coping behaviours. Results Of 2203 IDPs surveyed, 8.4% of men and 0.7% of women screened positive for AUD (AUDIT &gt;7). Among current drinkers, AUD was present in 14.9% of men and 1.8% of women. Age, cumulative trauma exposure and anxiety were significantly associated with AUD in multivariable analysis. Alcohol users were 43% less likely to access health services for mental health compared with non-users. AUD was associated with more negative coping behaviours. Conclusions AUD is present within the male Ukrainian IDP population. Alcohol use was significantly associated with lower utilization of mental health services and more negative coping behaviours. AUD screening and low-intensity treatment services should be expanded for IDPs in Ukraine, particularly if integrated into mental health and psychosocial support programmes.

scholarly journals Impact of integrated district level mental health care on clinical and functioning outcomes of people with depression and alcohol use disorder in Nepal: a non-randomised controlled study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. J. D. Jordans ◽  
E. C. Garman ◽  
N. P. Luitel ◽  
B. A. Kohrt ◽  
C. Lund ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Psychological Treatment ◽  
Controlled Study ◽  
Primary Care Mental Health ◽  
Treatment Groups

Abstract Background Integration of mental health services into primary healthcare is proliferating in low-resource countries. We aimed to evaluate the impact of different compositions of primary care mental health services for depression and alcohol use disorder (AUD), when compared to usual primary care services. Methods We conducted a non-randomized controlled study in rural Nepal. We compared treatment outcomes among patients screening positive and receiving: (a) primary care mental health services without a psychological treatment component (TG); (b) the same services including a psychological treatment (TG + P); and (c) primary care treatment as usual (TAU). Primary outcomes included change in depression and AUD symptoms, as well as disability. Disability was measured using the 12-item WHO Disability Assessment Schedule. Symptom severity was assessed using the 9-item Patient Health Questionnaire for depression, the 10-item Alcohol Use Disorders Identification Test for AUD. We used negative binomial regression models for the analysis. Results For depression, when combining both treatment groups (TG, n = 77 and TG + P, n = 60) compared to TAU (n = 72), there were no significant improvements. When only comparing the psychological treatment group (TG + P) with TAU, there were significant improvements for symptoms and disability (aβ = − 2.64; 95%CI − 4.55 to − 0.74, p = 0.007; aβ = − 12.20; 95%CI − 19.79 to − 4.62; p = 0.002, respectively). For AUD, when combining both treatment groups (TG, n = 92 and TG + P, n = 80) compared to TAU (n = 57), there were significant improvements in AUD symptoms and disability (aβ = − 15.13; 95%CI − 18.63 to − 11.63, p < 0.001; aβ = − 9.26; 95%CI − 16.41 to − 2.12, p = 0.011; respectively). For AUD, there were no differences between TG and TG + P. Patients’ perceptions of health workers’ skills in common psychological factors were associated with improvement in depression patient outcomes (β = − 0.36; 95%CI − 0.55 to − 0.18; p < 0.001) but not for AUD patients. Conclusion Primary care mental health services for depression may only be effective when psychological treatments are included. Health workers’ competencies as perceived by patients may be an important indicator for treatment effect. AUD treatment in primary care appears to be beneficial even without additional psychological services.

scholarly journals Narrative review of mental illness in cricket with recommendations for mental health support

2021 ◽  
Vol 7 (1) ◽  
pp. e000910
Author(s):  
Thomas McCabe ◽  
Nicholas Peirce ◽  
Paul Gorczynski ◽  
Neil Heron
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Unmet Need ◽  
Narrative Review ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Anxiety Depression

IntroductionEpidemiology reporting within the cricketing medical literature has emerged over the past 2 years, with a focus on physical injuries. Despite mental health in elite sport gaining increasing recognition, few studies have addressed mental health symptoms and disorders within cricket. Recently, cricketers have been prominent in the mainstream media describing their lived experiences of mental illness. As a result, some have withdrawn from competition and suggested there is an unmet need for mental health services within the sport.Objectives(i) To appraise the existing evidence on mental health symptoms and disorders amongst cricketers. (ii) To provide guidance on shaping mental health research and services within cricket.DesignA narrative review of the literature from inception of available databases until 26 July 2019, with analysis and recommendations.ResultsFive studies were included in this narrative review. Studies covered a range of mental health symptoms and disorders, including distress, anxiety, depression, sleep disturbance, suicide, adverse alcohol use, illicit drug use, eating disorders and bipolar disorder. Results indicated that cricketers are at high risk for distress, anxiety, depression and adverse alcohol use. When compared with the general population, cricketers are more likely to experience anxiety and depressive symptoms. Rates of suicide were proposed to be high for test cricketers. Overall, studies to date have been of low quality, demonstrating non-rigorous research methods. Some studies have relied on non-validated questionnaires to collect self-reported data on mental health symptoms and disorders, while others have presented biographical data obtained through searches of the media.ConclusionsThe results of this narrative review highlight the lack of evidence underpinning mental health services for athletes within cricket. We suggest the following recommendations for future research and practice: (i) normalising mental health symptoms and disorders; (ii) working with and helping vulnerable demographic segments within the target population; (iii) designing and implementing early recognition systems of mental health symptoms and disorders; (iv) addressing the mental health needs of cricketers on a population basis.

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