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| 2. |
- Nehlin, Christina, 1958-, et al.
(författare)
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Brief alcohol screening in a clinical psychiatric population : Special attention needed
- 2012
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 31:4, s. 538-543
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and aims: Abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) and single-item screeners show promising results but have not previously been investigated in a clinical psychiatric setting. The aim of the present study was to investigate the capacity of three brief screening methods to detect hazardous drinking in a psychiatric treatment-seeking population.Design and methods: Data was collected from consecutive patients (n = 1811) visiting a general psychiatric clinic. The screening capacity of the Heavy Episodic Drinking (HED) screener, AUDIT item # 3 (AUDIT-3) and the three consumption items of AUDIT (AUDIT-C) was compared to the result of the full 10-item AUDIT with cut-off points 6 for females and 8 for males.Results: The HED screener and AUDIT-3 with recommended cut-offs captured low rates of hazardous drinkers when compared to the full AUDIT. Lowering the cut-offs created rates far above those of the full AUDIT. AUDIT-C with recommended cut-off limits categorised nearly the same rates of males as the full AUDIT but much higher rates of females. Raising the cut-off for females approached the detection rate of AUDIT-C closely to that of the full AUDIT.Discussion and conclusions:The findings of this study suggest that the HED screener is not sensitive enough in the clinical psychiatric setting. When designing alcohol screening measures to be used all over health care organisations, special attention should be paid to psychiatric patients. If a somewhat more extensive screening tool is used, the full AUDIT is recommended.
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| 3. |
- Nehlin, Christina, 1958-, et al.
(författare)
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Three hours of training improve psychiatric staff’s self-perceived knowledge and attitudes toward problem-drinking patients
- 2012
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 31:4, s. 544-549
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and aimsStaff attitudes are an important factor in the successful implementation of systematic alcohol strategies and policies. The forms and extent of training needed to improve therapeutic attitude among psychiatric staff to problem drinking are unclear. The aim of the investigation was to study the knowledge and attitudes of psychiatric staff toward problem drinking patients. A further aim was to investigate whether a short three-hour training is sufficient to improve knowledge and therapeutic attitude toward problem drinking.Design and methodsA tailored training model for psychiatric staff (non-physicians) was carried out at a medium size university clinic. Participants were medical (nurses and psychiatric aides) and non-medical staff (psychologists and social workers). The training consisted of a two-hour workshop and a one-hour follow-up session. Knowledge and attitudes were measured at baseline and follow-up by a questionnaire including vignettes assessment and the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ).Results In total, 115 persons completed the questionnaire (follow-up rate 83.5 %). The distribution was even (50 % for the medical and 50 % for the non-medical staff). After training, the non-medical staff estimated vignette case severity higher than before. Both staff groups estimated their capacity to help a patient with complex problems higher after training. Role adequacy was higher in both subgroups after training. Medical staff scored Work satisfaction higher after the training. Discussion and conclusionsThree hours of tailored training for psychiatric staff improve their knowledge and therapeutic attitude to problem drinking patients.
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- Norström, Thor, 1948-
(författare)
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Alcohol and homocide in the United States - is the link dependent on wetness?
- 2011
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 30:5, s. 458-465
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and Aims. Several aggregate-level studies have suggested that the relationship between alcohol and homicide is stronger in countries with an intoxication-oriented drinking pattern than in countries where drinking is more tempered. The present paper extends this research tradition by analysing the alcohol–homicide link in various regions in the USA. Design and Methods. I used annual time-series data for the US states covering the period 1950–2002. Alcohol sales figures were used as proxy for alcohol consumption. Mortality data were used as indicators of homicide. The states were sorted into three groups labelled Dry, Moderate and Wet, where the last group has the highest prevalence of hazardous drinking according to survey data. Group-specific data were analysed using (i) autoregressive integrated moving average (ARIMA) modelling and (ii) fixed effects modelling. All modelling was based on differenced data, thus eliminating time trends and interstate correlations, both of which may bias estimates. Results. The ARIMA estimates displayed a statistically significant gradient in alcohol effects; the effect was strongest in Wet, and weakest and insignificant in Dry states. The fixed-effects estimates showed a corresponding pattern, although the gradient was less steep and insignificant. The gradient was also weakened if the effects were expressed in absolute rather than relative terms. The spatial pattern revealed no ecological correlation between alcohol and homicide. Discussion and Conclusions. Results provided mixed support for the hypothesis that the relationship between alcohol and homicide is stronger in wet than in dry states in the USA. Future research should probe more specific indicators of homicide as well as alcohol consumption.
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| 5. |
- Norström, Thor, 1948-, et al.
(författare)
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The importance of alcoholic beverage type for suicide in Japan : A time-series analysis, 1963-2007
- 2012
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 31:3, s. 251-256
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Tidskriftsartikel (refereegranskat)abstract
- Background. Japan has one of the highest suicide rates in the world. Cohort analysis has suggested that alcohol consumption is a risk factor for suicide in Japan. However, this relationship has not been observed at the population level when a measure of per capita total alcohol consumption has been analysed. The present study employed a time-series analysis to examine whether these contradictory findings may be due to the existence of beverage-specific effects on suicide. Methods. An autoregressive integrated moving average model was used to assess the relationship between the consumption of different types of alcohol and suicide rates from 1963 to 2007. The data comprised age-adjusted suicide rates for the ages 15-69, and information on beverage-specific alcohol consumption per capita (15+). The unemployment rate was included as a control variable. Results. During 1963-2007, male suicide rates increased substantially whereas female rates decreased slightly. Consumption of distilled spirits was significantly related to male suicide rates (but not in women) with a 1 L increase in consumption associated with a 21.4% (95% confidence interval: 3.2-42.9) increase in male suicide rates. There was no statistically significant relationship between suicide and any other form of alcohol consumption (beer, wine, other alcohol). Conclusion. This is the first study that has shown an association between spirits consumption and male suicide in Japan. Potentially beneficial policy changes include increasing spirits prices through taxation, reducing the physical availability of alcohol and discouraging the practice of heavy drinking.
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- Ramstedt, Mats
(författare)
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Population drinking and homicide in Australia : A time series analysis of the period 1950-2003
- 2011
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 30:5, s. 466-472
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Tidskriftsartikel (refereegranskat)abstract
- Background. Despite a significant amount of research on alcohol and homicide in Australia, as yet there has been no study of the association at the aggregate level to reveal where Australia fits in with respect to the cultural differences found in the international research of this association. Aims. To analyse the temporal association between population drinking and homicide in Australia and to put the results in an international comparative perspective. Method. Using Autoregressive Integrated Moving Average (ARIMA) time series analysis, overall and gender-specific homicide rates from 1950 to 2003 were analysed in relation to alcohol consumption overall as well as to different beverages. Findings. A one-litre increase in per capita consumption was followed by an 8% increase in overall and male homicide rates and a 6% increase in female homicide rates. The effect was mainly driven by beer consumption. In a comparative perspective, the importance of population drinking was similar to what has been found inWestern Europe. Conclusions. Australia belongs to the group of countries where lowering population drinking is likely to be associated with lower homicide rates and reducing beer consumption seems to be the most efficient way to achieve this. [Ramstedt M. Population drinking and homicide in Australia: A time series analysis of the period 1950-2003.
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| 7. |
- Room, Robin, et al.
(författare)
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Clear criteria based on absolute risk : Reforming the basis of guidelines on low-risk drinking
- 2012
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 31:2, s. 135-140
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Tidskriftsartikel (refereegranskat)abstract
- Issues. The paper discusses the approach behind the Australian Guidelines to Reduce Health Risks from Drinking of 2009. The Guidelines involved a new approach to the central conundrum of low-risk drinking guidelines: how to set a guideline threshold on smooth risk curves. Approach. The context of the 2009 Guidelines is discussed in terms of previous Australian guidelines and of risk analyses and threshold setting for other risks to health and well-being, such as environmental and food toxins. The Guidelines were accordingly based on new lifetime risk modelling of absolute risk, with specification of the risk attached to the guideline thresholds of 1 in 100 lifetime mortality risk. The Guidelines thus specify no more than two Australian standard drinks a day, and no more than four drinks on any occasion. Implications and Conclusions. The approach described brings alcohol guidelines within a general analytical frame of guidelines and standards for hazards to health. At the level of 1 in 100 lifetime risk, there is little justification for different guidelines for men and women. On grounds of differential risk, separate guidelines for young adults might be considered, but could not be based on lifetime risk. [ Room R, Rehm J. Clear criteria based on absolute risk: Reforming the basis of guidelines on low-risk drinking.
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| 9. |
- Scheffel Birath, Christina, et al.
(författare)
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Women with alcohol problems : The possible significance of personality clustering for treatment planning
- 2011
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 30:2, s. 207-215
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and Aims. Establishing subgroups in clinical practice is important for treatment planning. The aim of the study was to cluster the study group subjects according to personality traits and psychological health variables and to establish possible differences in treatment outcome in terms of: (i) drinking outcomes (gram and number of drinking days); (ii) perceived physiological health; and (iii) use of treatment resources (length of time in treatment and number of visits) among 134 treatment-seeking women with alcohol problems in a clinical context, between the two clusters obtained. Design and Methods. Data were collected from 134 consecutive women at a Swedish clinic specialised in treating women with alcohol problems. A hierarchical cluster analysis was performed on the basis of self-rated personality scale scores and psychological health variables. Results. Two clusters were identified: one in which the women displayed personality and psychological health scores indicating problems (Cluster 1); and another where the women showed personality and psychological health scores within the norm range (Cluster 2). Alcohol consumption rates at the start of treatment were the same in both clusters. The consumption rates were also the same at the end of treatment for the cluster, showing a significant decrease in alcohol consumption in each. The Cluster 1 women, however, had a significantly higher number of visits at the clinic, and rated the consequences of their alcohol drinking as being significantly worse than Cluster 2 women. Discussion and Conclusions. The importance of individual differences according to personality traits for treatment planning is discussed in terms of the need for variation in treatment time and methods.
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