| 1. |
- Spak, Lena, 1949, et al.
(författare)
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Factors in childhood and youth predicting alcohol dependence and abuse in Swedish women: Findings from a general population study
- 1997
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Ingår i: Alcohol and Alcoholism. - 0735-0414. ; 32:3, s. 267-274
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to assess risk factors during childhood and youth for alcohol dependence/abuse (ADA) in a population-based study of Swedish women. A total of 316 women were interviewed after stratified random sampling in the general population and a screening questionnaire. The interviews focused on social, psychological and behaviour characteristics as well as on early substance use patterns. Alcohol diagnoses were made according to DSM-III-R and CIDI-SAM. Experiences of sexual abuse before the age of 13 years, a history of psychological or psychiatric problems, early deviant behaviour and an episode of alcohol intoxication before the age of 15 years were significantly associated with ADA in a logistic model. General indicators of low social class were not associated with increased risk of ADA in a multivariate analysis. Sexual abuse in childhood was the strongest predictor of ADA. This association has potential public health importance, and should be addressed in future studies on women and alcohol. PMID: 9199727 [PubMed - indexed for MEDLINE]
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| 2. |
- Spak, Lena, 1949, et al.
(författare)
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Sexual abuse and alcoholism in a female population
- 1998
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Ingår i: Addiction. - 0965-2140. ; 93:9, s. 1365-1373
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: (1) To study the prevalence of childhood sexual abuse before the age of 18 years (CSA) and life-time sexual abuse (LSA) in a Swedish female, general population, (2) to analyse associations between CSA and life-time alcohol dependence or abuse (ADA), and (3) to identify possible confounding factors. DESIGN AND PARTICIPANTS: The study was conducted in two phases. Phase 1: an alcohol problem screening questionnaire was sent to 3130 women aged 25-65. The answers were scored. Phase 2: based on the questionnaire scores, a randomly selected stratified sample of 479 women was invited for an interview. Of these, 316 women participated in a structured face-to-face interview. SETTING: A sector of Göteborg city with 100,000 inhabitants. MEASUREMENTS: The interviews focused on substance use and on social, psychological and behavioural characteristics, including experiences of sexual abuse. Clinical psychiatric diagnoses were made according to DSM-III-R. Bivariate analyses and multivariate logistic regression analyses were performed. FINDINGS: The prevalence of CSA and LSA was 9.8% and 13.9%, respectively. CSA increased the risk for life-time ADA and anxiety, but not for depression. When potential confounding factors (e.g. early background factors, depression and anxiety) were adjusted for, CSA under 13 years of age still predicted ADA in multivariate analyses, but CSA under 18 years of age did not. CONCLUSIONS: LSA, and especially CSA under 13 years of age, are factors that should be considered in treatment of women with ADA and in psychiatric treatment of women. PMID: 9926542 [PubMed - indexed for MEDLINE]
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| 3. |
- Gerdner, Arne, et al.
(författare)
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Abscondance and length of treatment in locked wards for compulsorily committed alcoholics in relation to treatment program and legal changes
- 1997
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Ingår i: Scandinavian Journal of Social Welfare. - 0907-2055. ; 6:4, s. 310-316
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Tidskriftsartikel (refereegranskat)abstract
- Describes a study of alcoholics compulsorily committed to a locked ward in a coercive treatment setting in Sweden. Finds that the introduction of an Alcoholics Anonymous - oriented programme in a coercive treatment setting reduced the time spent on a locked ward without increasing the number of times patients absconded. Increase in length of coercion increased both the time spent at the locked ward and the number of times absconded.
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| 4. |
- Gerdner, Arne, et al.
(författare)
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Explaining inconsistancy between patient and collateral : Validity in outcome studies of coercive alcoholism treatment
- 1996
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Ingår i: Scandinavian Journal of Social Welfare. - : Wiley. - 0907-2055. ; 5:1, s. 12-18
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to assess the consistency of replies to questionnaires mailed to patients and two kinds of collaterals, i.e., social workers and significant others, at a public treatment center with socially unstable and compulsory committed patients. It compares the quantity and kind of discrepancies between replies by patients and collaterals on outcome data concerning social situation and drinking habits. It aims to measure the amount of systematic bias among factors that may explain inconsistencies between reports, especially the factors compulsory commitment, worse outcome, frequency of contact and type of collateral. The responders generally agreed. Variables in which there was less agreement were explored in logistic regressions using ten explanatory variables. Significant relations did not exceed those expected by chance. Discrepancies were not systematic in size and kind. On a six-rank ordinal scale of alcohol use or abuse, however, patients tended to underestimate the extent of their abuse. Inconsistencies here concerned the degree but not the presence of abuse. No difference in consistency due to type of collateral was found. In conclusion, the consistency of the questionnaires was high and independent of the social situation of the patient, of compulsory commitment and of other background or treatment factors, as well as of treatment outcome and type of collateral.
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| 5. |
- Gerdner, Arne, et al.
(författare)
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Mortality of treated alcoholics after eight years in relation to short-term outcome
- 1997
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Ingår i: Alcohol and Alcoholism. - 0735-0414 .- 1464-3502. ; 32:5, s. 573-579
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Tidskriftsartikel (refereegranskat)abstract
- This study concerns the relation between mortality and the short-term outcome of inpatient treatment for alcoholism. A total of 121 patients (87 men, 34 women) were included, of whom 89 were voluntary and 32 compulsorily committed. They had a mean age of 41±7 (SD) years and attended a 5-week programme at Runnagården, Örebro, Sweden. Most patients were socially unstable and severely alcohol-dependent. Ten months (mean) after discharge, 96% of the patients and their referring social workers were contacted with mail questionnaires. Of these patients, 13% had been totally abstinent and a further 42% improved but had had relapses. After a mean of 8.5±0.27 years, 27 patients (24%) had died. All abstainers survived, but non-abstainers had nine-fold higher mortality than expected. Non-abstinent improved women tended to survive longer than non-improved women, but among non-abstinent improved men no such tendency was found. In conclusion, a reduction in the frequency and quantity of abusive drinking was not enough to reduce the higher risk of death. Only abstinence seemed to be preventive.
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| 6. |
- Gerdner, Arne, et al.
(författare)
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Prediction of outcome in coerced and voluntarily treated alcoholics
- 1996
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Ingår i: Scandinavian Journal of Social Welfare. - : Wiley. - 0907-2055. ; 5:2, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- The study concerns multivariate prediction of the short-term outcome of alcoholism in a coercive treatment setting in Sweden. One hundred and twenty-one patients (87 men, 34 women) with a mean age of 41 (range 26-63) years attended a 5-week programme. They were for the most part severely alcohol-dependent and socially unstable. Compulsorily committed patients (n=32) were less socially stable but did not differ from the voluntary patients (n=89) in the type of drugs abused or the severity of their dependence. Nine months (mean) after treatment, a follow-up was performed by mailing questionnaires to the patients and to the referring social workers. The improvement data in the questionnaires were checked with other data. Data on alcohol abuse were available for 116 (96%) of the patients. Fifty-five percent improved. Of these, 13% had remained entirely abstinent. Using multivariate logistic regression, participation in a self-help group and first-time admission were found to be significant factors for overall improvement, while having a family and more than primary education were significant for abstinence. Compulsory commitment to treatment was not related to the short-term drinking outcome. Undergoing voluntary treatment and having previous treatment experience were significant factors for participation in self-help groups.
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| 7. |
- Gerdner, Arne, et al.
(författare)
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Social workers and significant others as collaterals of non-responding alcoholics in follow-up studies using mail questionnaires and telephone inteviews
- 1998
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Ingår i: Scandinavian Journal of Social Welfare. - : Wiley. - 0907-2055. ; 7:1, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- The subject of this study is non-response to mail questionnaires and supplementary telephone interviews in evaluation of outcome of treatment for alcohol dependence. The study is based on two clinical populations (n= 121 and 603) from Runnagården, Sweden, a coercive care setting with both voluntary and compulsorily committed patients. The populations differed regarding size, treatment and background factors. Replies were obtained from two- and one-third of the patients in the two populations respectively. Replies from social workers were obtained in 67% and 57% of the cases respectively, and from significant others in 59% of a smaller sub-sample of the second population. With respect to the combination of patient and collaterals, we received at least one questionnaire reply concerning 96% and 79% of the two populations respectively. In this study we analysed non-response and evaluated two methods to remedy this, i.e., prediction of the outcome in non-responders from additional telephone follow-up and questionnaires to collaterals. About two-thirds of patients who replied had improved, compared with about one-third of non-responders. Significant others replied more often if patients had improved, while social workers replied more often if patients had not improved. Patients who did not reply to mail questionnaires, but answered the same questions in a telephone interview, differed in drinking outcome from non-responders, but not from mail respondents. The method of using questionnaires addressed to social workers as an additional source of data can be used in countries with a general system of social welfare services and is better than the use of significant others as collaterals. In conclusion, replies obtained by additional telephone interviews were not representative for patients who did not return mail questionnaires. Non-response groups were highly selected in each of the three questionnaires (addressed to patients, significant others and social workers). Since the selectivity had opposite tendencies, the combination of questionnaires to patients and to social workers seems to be the most representative.
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| 8. |
- Johnson, D H, et al.
(författare)
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Induction but not expression of behavioural sensitization to nicotine in the rat is dependent on glucocorticoids.
- 1995
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Ingår i: European journal of pharmacology. - 0014-2999. ; 276:1-2, s. 155-64
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Tidskriftsartikel (refereegranskat)abstract
- Behavioural sensitization has been implicated in the development of addictive behaviour, and several studies suggest that corticosteroids may be involved in this phenomenon. In the present study, the effects of adrenalectomy and steroid replacement treatments on the behavioural sensitization observed after daily injections of nicotine (0.4 mg/kg s.c.) were investigated in the rat. Adrenalectomy completely prevented sensitization to the locomotor stimulating effect of nicotine after repeated injections but did not influence the acute locomotor activating effect of the drug or an already established sensitization to nicotine. In adrenalectomized animals receiving replacement treatment with corticosterone or dexamethasone, but not aldosterone, repeated administration of nicotine produced behavioural sensitization. Repeated dexamethasone treatment per se failed, however, to sensitize rats to nicotine. Post mortem neurochemical studies showed that repeated administration of nicotine significantly increased homovanillic acid (HVA) levels, as well as the dihydroxyphenylacetic acid (DOPAC)/dopamine quotient, in the limbic forebrain. Adrenalectomy per se significantly increased HVA levels and tended to elevate the DOPAC/dopamine quotient. When repeatedly treated with nicotine, adrenalectomized rats displayed a higher DOPAC/dopamine quotient, but no significant difference in HVA levels, compared to nicotine-treated sham-operated controls. In the striatum and the cortex, no significant effects of nicotine treatment or adrenalectomy were observed on any of the neurochemical measures. The present results suggest that glucocorticoid (type II) receptor activation is required for induction of sensitization to the locomotor stimulatory effect of nicotine, whereas corticosteroids are not required for the expression of the behavioural sensitization once established. Provided that HVA levels and the DOPAC/dopamine quotient relatively well reflect the presynaptic dopamine activating effect of nicotine, it may be suggested that corticosteroid-related mechanisms associated with behavioural sensitization to nicotine are post- rather than presynaptically located in relation to mesolimbic dopamine neurons.
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| 9. |
- Söderpalm, Bo, 1959, et al.
(författare)
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Naloxone reverses disinhibitory/aggressive behavior in 5,7-DHT-lesioned rats; involvement of GABA(A) receptor blockade?
- 1999
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Ingår i: Neuropharmacology. - 0028-3908. ; 38:12, s. 1851-9
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Tidskriftsartikel (refereegranskat)abstract
- Effective medical treatment for impulsive aggression and several impulse control disorders is needed. Disinhibited, impulsive behavior of e.g. murderers, arsonists, suicidal patients, and patients suffering from antisocial personality or substance abuse disorders has been associated with signs of a deficiency in brain serotonin (5-HT) systems. Depletion of brain 5-HT consistently produces disinhibition and aggression also in experimental animals. The present series of experiments using a modified Vogel's conflict test indicates that the disinhibitory behavior of 5-HT-lesioned rats can be reversed by the commonly used opiate receptor antagonist naloxone at doses (0.1-5.0 mg/kg, s.c.) that do not significantly affect behavior in sham-lesioned controls. Moreover, this effect of naloxone, which resembles that previously observed after administration of negative modulators of gamma-aminobutyric acidA (GABA(A))/benzodiazepine receptor complexes, was reversed by a low inert dose (2.0 mg/kg, i.p.) of amobarbital. Furthermore, both naloxone (5.0 mg/kg, s.c.) and Ro 15-4513 (1.0 mg/kg, p.o.; a partial inverse agonist at benzodiazepine receptors) significantly decreased the number of attacks and the time spent in aggressive acts in 5,7-DHT-lesioned male residents. These results taken together with previous behavioral and neurochemical data suggest that the behavioral effects of naloxone observed here may involve an antagonistic action at brain gamma-aminobutyric acidA (GABA(A))/benzodiazepine receptor complexes. Thus, naloxone, its stable analogue naltrexone or other weak negative modulators of brain GABA(A)/benzodiazepine receptor complexes may represent a new pharmacological principle for the treatment of impulse control disorders.
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| 10. |
- Berglund, Mats, et al.
(författare)
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The influence of alcohol drinking and alcohol use disorders on psychiatric disorders and suicidal behavior
- 1998
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Ingår i: Alcoholism: Clinical and Experimental Research. - : Wiley. - 0145-6008 .- 1530-0277. ; 22:Suppl 7, s. 333-345
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Tidskriftsartikel (refereegranskat)abstract
- The present review reports on the influence of alcohol drinking and alcohol use disorders on psychiatric disorders and suicidal behaviour. The base of the study was previous reviews of the National Institute on Alcohol Abuse and Alcoholism publication Alcohol and Health in 1993 and by Helgason in 1996. Using a defined search strategy in Medline, another 42 articles from 1994 to 1996 were included in the comorbidity part and 19 in the suicidal part. Epidemiological and clinical studies confirm high comorbidity of substance use disorders and other mental disorders. Alcohol abuse worsens the course of psychiatric disorders. Light to moderate alcohol consumption has no documented positive effect on the course. Levels of risk consumption of alcohol in psychiatric disorders have not been well defined. One-fifth to one-third of increased deaths rate among alcoholics is explained by suicide. In countries with high alcohol consumption, the suicide rate is also high and is increasing with total increased alcohol consumption. Comorbidity is common among suicide victims, and substance use disorders is most frequently combined with depressive disorders. Interpersonal loss within 6 weeks before suicide is more often present among alcoholics than nonalcoholic suicide victims.
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