摘要:

The lifetime co‐morbidity of major psychiatric disorders among male alcoholics was examined with the structuredPsychiatric Diagnostic Interview(PDI), which was administered to 928 patients undergoing alcoholism treatment at six Veterans Administration Medical Centers. Thirty‐eight percent were positive for alcoholism only; 62% fulfilled inclusive lifetime diagnostic criteria for at least one other additional psychiatric syndrome. Thirty percent satisfied criteria for one additional syndrome; 16% for two additional syndromes; 12% for three; and 4% for four or more disorders in addition to alcoholism. Depression and antisocial personality were the most frequently identified co‐occurring syndromes (36% and 24%, respectively) followed by drug abuse and mania (17% each). The additional psychiatric syndromes in this sample were clearly not randomly distributed; instead, certain disorders tended to cluster together such as: drug abuse and antisocial personality; mania and depression; depression and anxiety disorder; and schizophrenia and affective disorder. Implications for classification and treatment are disc

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01425.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The organism frequently colonizing the stomach of patients suffering from chronic active gastritis and peptic ulcer disease–Helicobacter pylori–possesses marked alcohol dehydrogenase (ADH) activity. Consequently,Helicobacterinfection may contribute to the capacity of the stomach to metabolize ethanol and lead to increased acetaldehyde production. To study this hypothesis, we first determined ADH activity in a variety ofH. pyloristrains originally isolated from human gastric mucosal biopsies. ADH activity was also measured in endoscopic gastric mucosal specimens obtained fromH. pylori‐positive and ‐negative patients. Furthermore, we used a mouse model ofHelicobacterinfection to determine whether infected animals exhibit more gastric ethanol metabolism than noninfected controls.Most of the 32H. pyloristrains studied possessed clear ADH activity and produced acetaldehyde. In humans, gastric ADH activity of corpus mucosa did not differ betweenH. pylori‐positive and ‐negative subjects, whereas in antral biopsies ADH activity was significantly lower in infected patients. In mice, gastric ADH activity was similar or even lower in infected animals than in controls, depending on the duration of infection, despite the fact that the infectious agent used–Helicobacter felis–showed ADH activity in vitro. In accordance with this,Helicobacterinfection tended to decrease rather than increase gastric ethanol metabolism in mice. In humans, it remains to be established whether the observed decrease in antral ADH activity associated withH. pyloriinfection can lead to reduced gastric first‐pass meta

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01426.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Event‐related potentials (ERPs) were recorded from 83, 21‐ to 25‐year‐old nonalcoholic men varying in alcoholism vulnerability due to the presence/absence of an alcoholic family history or a personal history of antisocial personality disorder. ERPs were elicited by a visual oddball task in which the target was presented more frequently than the nontarget, in order to elicit impulsive or perseverative responding. Analyses of N200 and P300 revealed no group differences in the nontarget response. However, analyses of the target response revealed a significantly smaller P300 in the antisocial personality (ASP)+ group compared with the ASP‐ group. The P300 decrement was limited to frontal electrode sites and is interpreted as indicating the presence of subtle anterior brain dysfunction among ASP+

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01427.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study explores the potential for the development of a surrogate for alcohol‐involved traumatic injury. It presents a bivariate probit analysis that simultaneously models likelihoods of patients being tested for blood alcohol content (BAC) and having positive BACs given testing using 17,356 adult trauma cases selected from the California Regional Trauma Registry. It concludes that patient and injury characteristics predict both testing and BAC, and that a weighting scheme may be profitably used to determine changes in levels of alcohol‐involved trauma in populations over time in the absence of empirical measurement of

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01428.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Cerebrospinal fluid (CSF) was obtained from 17 patients during acute alcohol withdrawal. Eight of these 17 patients had a second lumbar puncture a mean of 11.9 ± 8.1 (sd) days later, when the clinical signs of alcohol withdrawal had subsided. CSF 3‐methoxy‐4‐hydroxyphen‐ylglycol concentrations declined significantly (p<0.05) during the course of alcohol withdrawal from 52.0 ± 22.1 (sd) to 39.6 ± 12.6 pM/ml. In early withdrawal, there was a significant positive correlation between CSF norepinephrine (NE) and corticotropin releasing hormone (CRH) concentrations (r= 0.95,p<0.001). Both NE and CRH concentrations correlated positively with diastolic blood pressure (r= 0.88,p<0.001 andr= 0.62,p<0.05, respectively). In all samples, CSF 5‐hydroxyindole acetic acid concentrations correlated positively with CSF‐homovanillic acid concentrations (r= 0.83,p<0.001). These findings indicate significant perturbations of the noradrenergic neuronal system and a change in CRH‐NE interactions during acute al

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01429.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

All patients ≥60 years of age who were first‐time admitted to the Department of Alcohol Diseases in Malmö during 1988–1992 were investigated, a total of 218 men and 64 women. Several clinical variables were assessed addressing gender differences. The sex ratio (female:male) in this elderly population was compared with the corresponding ratio of one decade previously (1978‐1982). The main findings were that similarities were more common than dissimilarities, except age of onset problem drinking that occurred significantly later in the female patients (p<0.05). Sex ratios indicated a significant convergence of female patients to that of males during 1988–1992, compared with one decade earlier (1:3.4 and 1:7.8, respectively;p<0.01). The former ratio resembled the one found in the younger age groups. Conceivable explanations of the convergence are discus

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01430.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The marker characteristics of monoamine oxidase B (MAO B) in human platelets were investigated in a clinical study of 59 alcoholics (diagnosed according to the criteria of ICD‐10) observed over a period of 6 months. Demographic and family history were obtained by a structured interview, including the substance abuse section of CIDI (Composite International Diagnostic Interview). The patient's personality was assessed by Cloninger's Tridimensional Personality Questionnaire (TPQ). Blood samples were first drawn during chronic intoxication (day of admission to the hospital for detoxication), after short‐term abstinence (8 days later), medium‐term (3 months later), and long‐term abstinence (6 months later).A group of 22 matched healthy nonalcoholics served as controls studied under sober conditions and during acute intoxication (4 hr after ingestion of 1 g ethanol/kg body weight). All platelet samples were investigated with 6 kynuramine concentrations as substrate (fluorometric assay) in the absence and presence of 200 itim ethanol (ETOH) in vitro.MAO B activity was significantly reduced in alcoholics during chronic intoxication (Vmax: 2.70 ± 0.15 nmol/min/mg protein) compared with sober (Vmax: 3.25 ± 0.23 nmol/min/mg protein) and acutely intoxicated controls that turned to normal during abstinence. However, MAO B activity obtained during medium‐ and long‐term abstinence was significantly lowered in patients with high novelty‐seeking and impulsiveness scores in the TPQ, a history of suicide attempts, or an alcoholic mother. The affinity of MAO B (Kmvalues) was unchanged in alcoholics at any time investigated. Addition of ETOH in vitro reduced the affinity. This effect was less pronounced when the blood had been obtained during chronic intoxication and after short‐term abstinence, suggesting tolerance toward ETOH.It is demonstrated that reduced MAO B values may serve as state and trait markers of alcoholism and that they can be disentangled in a longitudinal

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01431.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study examined the distribution of alcohol‐related and other dementias in a sample of 130 cognitively impaired residents of long‐term care facilities in a Northern Ontario community. Study procedures entailed standardized psychiatric, neurological, and neuropsychological evaluations. Diagnoses of dementia of the Alzheimer type (DAT) and vascular dementia were based on criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. The diagnosis of alcohol‐related dementia (ARD) was based on extensive review of medical history to assess before alcohol abuse and stabilization or improvement in cognitive functioning following institutionalization in conjunction with no other identifiable cause of dementia. ARD comprised 24% of this population compared with DAT (35%), vascular dementia (19%), and other causes (22%). The ARD group was, on average, 10 years younger than the other groups. It had nearly twice the average length of institutionalization and had milder cognitive impairment on both clinical ratings and neuropsychological tests. A diagnosis of ARD was present in the medical records for only 25% of patients in this group. These findings suggest that ARD may be more common than previously suspected in the distribution of dementias in long‐term care fac

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01432.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The suitability of fitting a two‐parameter logistic item response model to the Drug Use Screening Inventory (DUSI) was assessed. In a sample of 846 adolescents, each of the 10 domains was found to be unidimensional. Invariance of the item parameters across different groups was also observed. The reliability coefficient, based on item response theory, was found to be superior. The results of these analyses indicate that the DUSI has sound psychometric propertie

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01433.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Gender differences in alcohol consumption components, hazardous alcohol consumption, and drinking patterns among Spaniards were analyzed. The study was conducted in the fall of 1992 on 2,500 individuals, aged 14–70 years, who lived in the region of Castile and Leon (Spain). Males drank more frequently (with a high intake of alcohol), were more likely to be hazardous drinkers, and started drinking earlier than females. Both sexes drank beer in a similar way, but not wine and spirits. Males and females gave similar reasons for drinking and showed similar patterns of “family” drinking, although sex differences in other patterns of alcohol consumption were found. The relevance of results was disc

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb01434.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY