scholarly journals Hospital morbidity and alcohol consumption in less severe psychiatric disorder: 7-year outcomes

2006 ◽  
Vol 188 (6) ◽  
pp. 554-559 ◽  
Author(s):  
Robert J. Tait ◽  
Gary K. Hulse

BackgroundSubstance use by people with severe psychiatric morbidity is associated with negative outcomes.AimsTo assess in adults with less severe psychiatric morbidity the relationship between alcohol consumption and subsequent 7-year hospital admissions, and the development and recurrence of alcohol use disorders.MethodFollow-up data were assembled via a population-based hospital record-linkage system.ResultsBaseline alcohol use groups were: dependent (n=31), harmful (n=114), moderate (n=621) and abstinent (n=249). The moderate but not the abstinent group had fewer mental health admissions and a longer time to first admission than the harmful and dependent groups. Both the moderate and the abstinent groups had longer times to ‘all-cause’ admissions than the dependent group. Many of those with alcohol use disorders at baseline relapsed (66%) but few (14%) developed a first-time alcohol use disorder.ConclusionsOverall, moderate alcohol consumption among those with less severe psychiatric morbidity was not associated with more mental health admissions; those with alcohol dependence had poorer health outcomes than the remaining categories.

2013 ◽  
Vol 7 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Christopher N. Kaufmann ◽  
Lainie Rutkow ◽  
Adam P. Spira ◽  
Ramin Mojtabai

AbstractObjectivesTo determine the prevalence of mental disorders in a nationally representative sample of protective services workers (PSWs), compare it to that of adults in other occupations, and determine if an association exists between trauma exposure and 3-year incident psychiatric disorders in PSWs.MethodsData from the longitudinal US National Epidemiologic Survey on Alcohol and Related Conditions waves 1 (fielded 2001-2002) and 2 (fielded 2004-2005) were used to compare the prevalence of mental disorders at baseline in a representative sample of PSWs to that of adults in other occupations. Among PSWs, we also explored the association between recent exposure to potentially traumatic events and the development of mood, anxiety, and alcohol-use disorders over a 3-year follow-up period.ResultsAt baseline, PSWs had a lifetime prevalence of mental and alcohol-use disorders similar to that of adults in other occupations. However, PSWs experienced a greater variety of potentially traumatic events between baseline and follow-up. Exposure to a greater number of different trauma types was associated with increased odds of incident mood (adjusted odds ratio [AOR] = 1.87, 95% CI = 1.09-3.22, P = .024), and alcohol-use disorders (AOR = 1.84, 95% CI = 1.16-2.91, P = .011). These associations were particularly strong among early career PSWs who joined the profession between waves 1 and 2 (AOR = 2.30, 95% CI = 1.26-4.19, P = .008, for mood disorders; AOR = 2.44, 95% CI = 1.30-4.58, P = .007, for alcohol-use disorders).ConclusionsWhile PSWs do not appear to have a higher prevalence of mental health problems than workers in other occupations, they are more likely to experience multiple types of potentially traumatic events. PSWs who are exposed to multiple types of potentially traumatic events are at increased risk of developing new mental disorders, particularly in the early stages of their careers. Developing curricula in coping skills and providing timely interventions for early career PSWs may help reduce future psychiatric morbidity in these workers. (Disaster Med Public Health Preparedness. 2013;7:36-45)


2017 ◽  
Vol 07 (06) ◽  
Author(s):  
Chun Te Lee ◽  
Chiu Yueh Hsiao ◽  
Yi Chyan Chen ◽  
Oswald Ndi Nfor ◽  
Jing Yang Huang ◽  
...  

2021 ◽  
Author(s):  
Kinsey Pebley ◽  
Indika Mallawaarachchi ◽  
G Wayne Talcott ◽  
Melissa A Little

ABSTRACT Introduction Alcohol use is prevalent among military personnel, with many engaging in binge drinking behaviors. Military trainees are unique, in that they experience an enforced alcohol ban for 8 weeks while in Basic Military Training. However, they are also typically young adults, who consume alcohol at higher rates than any other age group. The current study aimed to describe alcohol consumption among trainees, determine when, where, and with whom Airmen drank for the first time during Technical Training, and if these patterns were significantly different based on descriptive norms (i.e., beliefs about how many other individuals engage in a certain behavior) related to alcohol use, given that most military members consume alcohol. Last, we aimed to determine if alcohol consumption or potential alcohol use disorders were significantly different based on descriptive norms. Materials and Methods Airmen (n = 599) were recruited at Joint Base San Antonio—Fort Sam Houston during their last week of Technical Training to complete a survey. Study procedures were approved by the 59th Medical Wing Institutional Review Board. Participants were asked about their beliefs related to how many other Airmen drink alcohol (i.e., less than 50%, 50%, or greater), their own experiences with alcohol (e.g., how much they drink compared with consumption before military service, blackouts after drinking during Technical Training), and when, where, and with whom they consumed alcohol for the first time after beginning military training. Results Over half of the Airmen reported not engaging in drinking behaviors during Technical Training. Among those who reported drinking one or more drinks during Technical Training, most reported drinking the same amount or less than they did prior to Basic Military Training. The majority of Airmen reported that they had “maybe” experienced blackouts from drinking since Technical Training. Most Airmen drank for the first time with another someone who was not an Airman, at a restaurant, home, or other place off base, and while they were on leave. Results indicated no significant differences between groups related to beliefs about how many Airmen drink during Technical Training and where, when, and with whom Airmen drank for the first time since joining the Air Force. There were also no differences in Alcohol Use Disorders Identification Test scores or drinks per week between these normative belief groups. Conclusions Almost half of Airmen resume drinking after alcohol restrictions are lifted during Technical Training but maintain low numbers of drinks consumed per week and low risk for alcohol use disorders, which may indicate that this is an opportune time for intervention to prevent alcohol consumption from escalating over time. Airmen reported drinking for the first time with another Airman off base during leave. Focusing on how Airmen navigate alcohol-related decision-making while their responsibilities are reduced, or how other Airmen influence their decisions to engage in risky drinking, may help prevent alcohol use rates from increasing post-enforced ban.


2020 ◽  
Vol 8 (2) ◽  
pp. 1-144 ◽  
Author(s):  
Paolo Deluca ◽  
Simon Coulton ◽  
Mohammed Fasihul Alam ◽  
Sadie Boniface ◽  
Kim Donoghue ◽  
...  

Background Alcohol consumption and related harm increase steeply from the ages of 12–20 years. Adolescents in the UK are among the heaviest drinkers in Europe. Excessive drinking in adolescents is associated with increased risk of accidents, injuries, self-harm, unprotected or regretted sex, violence and disorder, poisoning and accidental death. However, there is lack of clear evidence for the most clinically effective and cost-effective screening and brief interventions for reducing or preventing alcohol consumption in adolescents attending emergency departments (EDs). Objectives To estimate the distribution of alcohol consumption, alcohol-related problems and alcohol use disorders in adolescents attending EDs; to develop age-appropriate alcohol screening and brief intervention tools; and to evaluate the clinical effectiveness and cost-effectiveness of these interventions. Design The research has been conducted in three linked stages: (1) a prevalence study, (2) intervention development and (3) two linked randomised controlled trials (RCTs). Setting Twelve EDs in England (London, North East, and Yorkshire and The Humber). Participants A total of 5376 participants in the prevalence study [mean age 13.0 years, standard deviation (SD) 2.0 years; 46.2% female] and 1640 participants in the two linked RCTs (mean age 15.6 years, SD 1.0 years; 50.7% female). Interventions Personalised feedback and brief advice (PFBA) and personalised feedback plus electronic brief intervention (eBI), compared with alcohol screening alone. These age-appropriate alcohol interventions were developed in collaboration with the target audience through a series of focus groups and evaluations during stage 2 of the research programme and following two literature reviews. Main outcome measures Total alcohol consumed in standard UK units (1 unit = 8 g of ethanol) over the previous 3 months at 12-month follow-up, assessed using the Alcohol Use Disorders Identification Test, Consumption (3 items) (AUDIT-C). Results In the prevalence study, 2112 participants (39.5%) reported having had a drink of alcohol that was more than a sip in their lifetime, with prevalence increasing steadily with age and reaching 89.5% at the age of 17 years. The prevalence of at-risk alcohol consumption was 15% [95% confidence interval (CI) 14% to 16%] and the optimum cut-off point of the AUDIT-C in identifying at-risk drinking was ≥ 3. Associations of alcohol consumption and early onset of drinking with poorer health and social functioning were also found. In the RCT, the analysis of the primary outcome (average weekly alcohol consumption at month 12) identified no significant differences in effect between the three groups in both trials. In the high-risk drinking trial, the mean difference compared with control was 0.57 (95% CI –0.36 to 1.70) for PFBA and 0.19 (95% CI –0.71 to 1.30) for eBI. In the low-risk drinking trial, the mean difference compared with control was 0.03 (95% CI –0.07 to 0.13) for PFBA and 0.01 (95% CI –0.10 to 0.11) for eBI. The health economic analysis showed that eBI and PFBA were not more cost-effective than screening alone. Conclusions The ED can offer an opportunity for the identification of at-risk alcohol use in adolescents. A simple, short, self-completed screening instrument, the AUDIT-C, is an effective tool for identifying adolescents who are at risk of alcohol-related problems. Associations of alcohol consumption and earlier onset of drinking with poorer health and social functioning were observed in the prevalence study. The trials were feasible to implement and exceeded the recruitment target and minimum follow-up rates. However, PFBA and eBI were not found to be more effective than screening alone in reducing or preventing alcohol consumption in 14- to 17-year-olds attending EDs. Limitations and future work Only one-third of participants engaged with the application program; this is likely to have limited the effect of the intervention. We recommend that future research should focus on methods to maximise engagement with digital interventions and evaluate the effect of such engagement on clinical outcomes. Trial registration Current Controlled Trials ISRCTN45300218. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 8, No. 2. See the NIHR Journals Library website for further project information.


2018 ◽  
Vol 72 (9) ◽  
pp. 856-863 ◽  
Author(s):  
Sören Kuitunen-Paul ◽  
Michael Roerecke

BackgroundWe summarise the evidence for an association between screening scores from the Alcohol Use Disorders Identification Test (AUDIT) and all-cause mortality.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, prospective cohort studies reporting all-cause mortality risk by AUDIT scores (complete AUDIT-10 or AUDIT-C) were identified through MEDLINE, Embase, PubMed and Web of Science up to September 2016. Risk estimates were pooled using random effects meta-analyses.ResultsSeven observational studies with 18 920 observed deaths among 309 991 participants were identified. At-risk drinking (ie, hazardous/harmful consumption, AUDIT-10 ≥8 and AUDIT-C ≥4) was associated with elevated mortality risk after 2–10 years of follow-up (pooled relative risk (RR)=1.24, 95% CI 1.12 to 1.37) compared with moderate drinking (AUDIT-10=1–7, AUDIT-C=1–3). Compared to past year abstainers (AUDIT=0), moderate drinkers had a lower mortality risk (RR=0.75, 95% CI 0.71 to 0.79) in US Veterans and a similar mortality risk (RR=0.99, 95% CI 0.72 to 1.38) in population-based studies. Most data came from studies among Veterans using the short AUDIT-C in men and showed a dose–response relationship (RR=1.04, 95% CI 1.04 to 1.05 for each AUDIT-C score among drinkers). Data for women and young adults were scarce.ConclusionAUDIT screening scores were associated with mortality risk. The association was differential depending on the population examined, which may be related to prevalence of former drinkers among current abstainers. Due to heterogeneity between studies and the small number of populations examined, generalisability may be limited.


Author(s):  
Jessica D. Hanson ◽  
Carolyn Noonan ◽  
Amy Harris ◽  
Kyra Oziel ◽  
Michelle Sarche ◽  
...  

Prior to the pandemic, our research team implemented a randomized controlled trial of an intervention to reduce risk for alcohol-exposed pregnancy (AEP) in American Indian women. When active recruitment for the in-person trial was paused due to COVID, the research team moved to conducting follow-up surveys with participants who had completed the intervention to better understand changes to their alcohol use during the pandemic. We collected surveys from 62 American Indian women who had completed the Native CHOICES intervention. Baseline data collected pre-COVID included demographics and scores on the Alcohol Use Disorders Identification Test (AUDIT). Follow-up surveys conducted during the active pandemic period included a self-reported questionnaire about changes in drinking patterns. At pre-COVID baseline, all participants were engaged in heavy or binge drinking. At follow-up during COVID, 24.2% reported drinking more, and over half had at least one binge drinking episode. Approximately half reported reduced drinking. We found that risky drinking remained an issue during the pandemic for many American Indian women who had engaged in this behavior pre-COVID, while others reported reducing their alcohol consumption. As the pandemic abates, concerted efforts must be made to reach those with identified alcohol use disorders to offer resources and intervention as needed.


2013 ◽  
Vol 55 (4) ◽  
pp. 376 ◽  
Author(s):  
Abhijit Nadkarni ◽  
Bhargav Bhat ◽  
Shah Ebrahim ◽  
Vikram Patel

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