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Treated and untreated individuals with alcohol use disorders: Rates and predictors of remission and relapse
Rudolf H. Moos,Bernice S. Moos
International Journal of Clinical and Health Psychology , 2006,
Abstract: Este estudio descriptivo observacional se centró en si los individuos con trastornos en el consumo de alcohol que reciben tratamiento profesional y/o participan en Alcohólicos Anónimos (AA) experimentan mejores resultados a largo plazo que los individuos que no obtienen ayuda. Los participantes fueron encuestados como línea de base cuando iniciaron la búsqueda de ayuda, y también pasados 1 a o, 3 a os, 8 a os, y 16 a os. En comparación con los individuos que no obtuvieron ayuda, aquellos individuos que participaron en tratamiento y/o AA durante 9 semanas o más en el primer a o presentaron mejores resultados en el plazo de 16 a os. La participación en tratamiento y/o AA aceleraron un patrón global de cambio, de modo que los individuos que obtuvieron ayuda mejoraron algo más y de forma más rápida que los otros. En general, la remisión fue menos probable para los individuos que no obtuvieron ayuda y, aun si la consiguieron, presentaron mayor probabilidad de reincidir. Los resultados apoyan la importancia de fortalecer el proceso de asesoramiento para los individuos que buscan ayuda, e indican que los proveedores deberían estructurar programas de tratamiento que favorezcan atención continua y afiliación con AA.
Individual and Community Level Risk-Factors for Alcohol Use Disorder among Conflict-Affected Persons in Georgia  [PDF]
Bayard Roberts, Adrianna Murphy, Ivdity Chikovani, Nino Makhashvili, Vikram Patel, Martin McKee
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098299
Abstract: Background The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia. Methods A cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs) and former IDPs. Two alcohol use disorder outcomes were measured: (i) having at least hazardous alcohol use (AUDIT score ≥8); (ii) episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week). Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only). Results Of the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386), 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use). Conclusion The findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for stronger alcohol control policies in Georgia.
Codependency in families with alcohol-dependent persons  [cached]
Aida Tolstikova
Medical and Health Science Journal , 2010,
Abstract: The article describes codependence problem in families with alcohol-dependent persons. Examination of author is based on observation of 15 families. The author argues that effective treatement of codependency appears when provided the integration of psychocorrectional, psychoterapeutic and biological (psychopharmacological) methods of influence.
Genes implicated in multiple sclerosis pathogenesis from consilience of genotyping and expression profiles in relapse and remission
Ariel T Arthur, Patricia J Armati, Chris Bye, Southern MS Genetics Consortium, Robert NS Heard, Graeme J Stewart, John D Pollard, David R Booth
BMC Medical Genetics , 2008, DOI: 10.1186/1471-2350-9-17
Abstract: In this study we investigated the gene expression profiles of peripheral blood cells from patients with RRMS during the relapse and the remission phases utilizing gene microarray technology. Dysregulated genes encoded in regions associated with MS susceptibility from genomic screens or previous trancriptomic studies were identified. The proximal promoter region polymorphisms of two genes were tested for association with disease and expression level.Distinct sets of dysregulated genes during the relapse and remission phases were identified including genes involved in apoptosis and inflammation. Three of these dysregulated genes have been previously implicated with MS susceptibility in genomic screens: TGFβ1, CD58 and DBC1. TGFβ1 has one common SNP in the proximal promoter: -508 T>C (rs1800469). Genotyping two Australian trio sets (total 620 families) found a trend for over-transmission of the T allele in MS in females (p < 0.13). Upregulation of CD58 and DBC1 in remission is consistent with their putative roles in promoting regulatory T cells and reducing cell proliferation, respectively. A fourth gene, ALOX5, is consistently found over-expressed in MS. Two common genetic variants were confirmed in the ALOX5 putatve promoter: -557 T>C (rs12762303) and a 6 bp tandem repeat polymorphism (GGGCGG) between position -147 and -176; but no evidence for transmission distortion found.The dysregulation of these genes tags their metabolic pathways for further investigation for potential therapeutic intervention.MS the most common cause of chronic neurological disability in young adults with a lifetime risk of one in 400 in northern Europeans [1]. Most patients have the relapsing-remitting (RR) form of MS characterised by episodes of neurologic impairment followed by complete or almost complete recovery [2]. A relapse is thought to be caused by some trigger of the immune system resulting in the trafficking of activated, myelin-reactive T-cells into the CNS through a disrupted blo
Early relapse after non myeloablative allogeneic stem cell transplantation in a patient with acute promyelocytic leukemia in complete molecular remission  [cached]
Tavernier E,Thomas Xavier
Indian Journal of Cancer , 2003,
Abstract: We described a 41-year-old patient with acute promyelocytic leukemia (APL) who experienced two successive relapses: one after all-trans retinoic acid (ATRA) treatment and chemotherapy, and another after ATRA treatment and chemotherapy, followed by autologous peripheral blood stem cell transplantation. A third complete remission (CR) was achieved with arsenic trioxide (As2O3) therapy. Mini-transplantation was performed as consolidation therapy. While the patient was in molecular remission at the beginning of conditioning regimen, a new relapse arose after transplantation at time of cell recovery. This raises a potential relationship between relapse and the severe immunosuppression induced by mini-transplantation. To our knowledge, this is the first description of a mini-allograft in an APL patient achieving molecular remission after As2O3 therapy.
Suppression by γ-Hydroxybutyric Acid of “Alcohol Deprivation Effect” in Rats: Preclinical Evidence of its anti-Relapse Properties  [PDF]
Giancarlo Colombo,Mauro A. M. Carai,Gian Luigi Gessa
Frontiers in Psychiatry , 2012, DOI: 10.3389/fpsyt.2012.00095
Abstract: γ-Hydroxybutyric acid (GHB) reduces (a) alcohol intake and alcohol motivational properties in alcohol-preferring rats and (b) alcohol drinking and craving for alcohol in human alcoholics. The present study was designed to extend to relapse-like drinking the capacity of GHB to suppress different alcohol-related behaviors in alcohol-preferring rats. The “alcohol deprivation effect,” defined as the temporary increase in alcohol intake occurring in laboratory animals after a period of alcohol deprivation, was used as model of alcohol relapse. Acute administration of non-sedative doses of GHB (0, 100, 200, and 300 mg/kg, i.p.) resulted in the complete suppression of the extra-amount of alcohol consumed by Sardinian alcohol-preferring rats during the first hour of re-access to alcohol after a 14-day period of deprivation. These data demonstrate that GHB suppressed relapse-like drinking in a rat model of excessive alcohol consumption.
Clinical and psychosocial remission in schizophrenia: correlations with antipsychotic treatment
Yoram Barak, Dov Aizenberg
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-108
Abstract: Psychiatric case managers rated psychosocial remission using the PsychoSocial Remission Scale (PSRS) and clinical remission using the Remission in Schizophrenia Working Group symptomatic remission criteria (RSWG). Ratings were performed for persons with schizophrenia they have been treating for 6 months or more. Data as to gender, age and pharmacological treatment of each patient were also collected.Of 445 participants who completed the survey, 268 (60%) were evaluated by psychiatrists, 161 (36%) by nurses and 16 (4%) were evaluated by social workers. Patients mean age was 43.4?+?13.1 years; 61% were men and 39% were women. Antipsychotic treatments were as follows: Per-os (PO) 243 (55%), IM long-acting typical antipsychotics (LAT) 102 (23%) and IM long-acting risperidone (RLAI; Consta) 100 (22%). Overall, 37% of patients achieved symptomatic remission and 31% achieved psychosocial remission. Rates of symptomatic remission were significantly higher in patients treated by LAT and RLAI compared with PO (51% and 48% vs., 29% respectively, p?=?0.0003). Rates of psychosocial remission were also significantly higher in patients treated by LAT and RLAI compared with PO (43%% and 41% vs., 24% respectively, p?=?0.003).In a large national sample a third of persons with schizophrenia were in remission. IM long acting preparations were associated with higher remission rates. Treatment choice may thus influence rates of remission in persons with schizophrenia.In recent years there has been an emphasis on meaningful clinical outcomes as well as focus on functional recovery in mental health. In schizophrenia, complete recovery implies the ability to function in the community, socially and vocationally, as well as being relatively free of disease-related symptomatology [1]. A consensus proposal by Andreasen et al. [2] presented criteria to define symptomatic remission in schizophrenia. The group proposed that symptom remission be based on maintenance of low level of symptoms for at
Full remission and relapse of obsessive-compulsive symptoms after cognitive-behavioral group therapy: a two-year follow-up
Braga, Daniela Tusi;Manfro, Gisele Gus;Niederauer, Kátia;Cordioli, Aristides Volpato;
Revista Brasileira de Psiquiatria , 2010, DOI: 10.1590/S1516-44462010000200012
Abstract: objective: the aim of this study was to assess whether the results obtained with 12 sessions of cognitive-behavioral group therapy with obsessive-compulsive patients were maintained after two years, and whether the degree of symptom remission was associated with relapse. method: forty-two patients were followed. the severity of symptoms was measured at the end of cognitive-behavioral group therapy and at 18 and 24 months of follow-up. the assessment scales used were the yale-brown obsessive-compulsive scale, clinical global impression, beck depression inventory, and beck anxiety inventory. results: the reduction in symptom severity observed at the end of treatment was maintained during the two-year follow-up period (f = 57.881; p < 0.001). at the end of the treatment, 9 (21.4%) patients presented full remission, 22 (52.4%) presented partial remission, and 11 (26.2%) had unchanged scores in the yale-brown obsessive-compulsive scale. after two years, 13 patients (31.0%) presented full remission, 20 (47.6%) had partial remission, and 9 (21.4%) had unchanged yale-brown obsessive-compulsive scalescores. the full remission of symptoms at the end of the treatment was a protective factor against relapse (χ2 = 4,962; df = 1; p = 0.026). conclusion: our findings underscore the importance of attaining full remission of obsessive-compulsive symptoms during treatment and the need for new therapeutic strategies to achieve this.
Community Mobilization and the Framing of Alcohol-Related Problems  [PDF]
Denise Herd
International Journal of Environmental Research and Public Health , 2010, DOI: 10.3390/ijerph7031226
Abstract: The goal of this study was to describe how activists engaged in campaigns to change alcohol policies in inner city areas framed alcohol problems, and whether or not their frameworks reflected major models used in the field, such as the alcoholism as a disease model, an alcohol problems perspective, or a public health approach to alcohol problems. The findings showed that activists’ models shared some aspects with dominant approaches which tend to focus on individuals and to a lesser extent on regulating alcohol marketing and sales. However, activists’ models differed in significant ways by focusing on community level problems with alcohol; on problems with social norms regarding alcohol use; and on the relationship of alcohol use to illicit drugs.
Comparison of Coping Mechanisms Between Alcoholics in Early Remission and Alcoholics in Remission at Least for 1 Year and Control Group  [PDF]
?ahinde ?zlem Erden AK?,Zehra ARIKAN,Sedat I?IKLI
N?ropsikiyatri Ar?ivi , 2008,
Abstract: Objective: To compare coping mechanisms and appraisal of coping skills at various stages of remission in patients with alcohol dependence.Method: This was a cross sectional study comparing the results of 3 groups including group 1- patients with alcohol dependence and, group 2-patients with alcohol dependence and in remission for at least 1 year and group 3 – a control group consisting of healthy individuals without any history of substance use except smoking. Hamilton Depression Scale, Coping with Stress Scale, Problem Solving Inventory, Rosenbaum’s Learned Resourcefulness Inventory, Rotter’s Locus of Control Scale, Beck Depression Scale, Beck Hopelessness Scale, State- Trait Anxiety Inventory and Minnesota Multiphasic Personality Inventory (MMPI) were completed for all subjects.Results: The control group and persons with at least one year of remission used adaptive coping mechanisms more frequently. Factors associated with the degree of alcohol dependence, such ase age at the start of alcohol use and daily alcohol consumption were found to affect coping mechanisms and appraisal of coping skills. Persons attending Alcoholics Anonymous (AA) meetings were found to use an indirect coping mechanism (seeking help), which is an adaptive coping skill in our culture, more frequently and were found to have less hopelessness.Conclusion: The results implied that patients with alcohol dependence who have been in remission more than 1 year and subjects attending AA meetings use adaptive coping mechanisms more frequently. It suggests coping skills treatment and attendance at AA meetings would improve long- term outcomes of alcohol dependence. (Archives of Neuropsychiatry 2008; 45: 37-47)
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