bluuebunny/crossref_metadata_2025_split huggingface dataset:
Excess alcohol consumption and health outcomes: a 6‐year follow‐up of men over age 50 from the health and retirement study
Authors: Perreira Krista M. , Sloan Frank A. 
Published: March 2003

ABSTRACTAims This study examined the association of problem drinking history and alcohol consumption with the onset of several health conditions and death over a 6‐year follow‐up period.Setting We analyzed two waves of longitudinal data on men over 50 who participated in the Health and Retirement Study, a nationally representative sample of people aged 51–61 and their spouses living in the United States in 1992.Measurements Five types of health outcomes—mortality, general health, functional status, cognitive status, and mental health—were examined. Drinking categories were based on average drinks per day (0, <1, 1–2, 3–4, 5+), with 5 + defined as ‘very heavy drinking’. Problem drinking history was identified as 2+ affirmative responses to the CAGE questionnaire. We controlled for smoking and other factors at baseline.Findings Over the 6‐year follow‐up period, very heavy drinking at baseline quadrupled the risk of developing functional impairments (OR: 4.21 95% CI: 1.67, 10.61). A problem drinking history increased the onset of depression (OR: 1.67 95% CI: 1.02, 2.74), psychiatric problems (OR: 2.15 95% CI: 1.47, 3.13) and memory problems (OR: 1.71 95% CI: 1.14, 2.56). Heavy drinking among mature adults was not associated with increased incidence of other adverse health events (i.e. angina, cancer, congestive heart failure, diabetes, myocardial infraction, lung disease or stroke).Conclusion Very heavy drinking and a problem drinking history greatly increased rates of onset of functional impairments, psychiatric problems and memory loss in late middle age for men who had not experienced these impairments at their initial interview.
The long‐term effectiveness of brief interventions for unsafe alcohol consumption: a 10‐year follow‐up
Authors: Wutzke Sonia E. , Conigrave Katherine M. , Saunders John B. , Hall Wayne D. 
Published: March 2003

ABSTRACTAims To examine the long‐term impact of brief and early interventions for hazardous and harmful alcohol consumption.Design A 9‐month and 10‐year follow‐up of subjects recruited into a randomized controlled trial of a range of alcohol‐related brief interventions.Setting General practices, the outpatient or acute care services of a major city hospital, and a privately run health screening programmeme.Participants The cohort of 554 (non‐dependent) hazardous and harmful drinkers recruited into the Australian arm of the Phase II World Health Organization collaborative project on identification and treatment of persons with harmful alcohol consumption.Intervention The effectiveness of three forms of intervention, ranging from 5 to 60 minutes in duration, were compared with a no‐treatment control condition.Measurements Included drinking behaviour and biological markers of alcohol use. In addition, at 10 years subjects were asked about symptoms of diagnosable alcohol use disorders and their experience of alcohol‐related psychological, social and physical harm. Mortality was also assessed.Findings Results provide further evidence for the short‐term effectiveness of alcohol‐related brief interventions. In comparison to controls, subjects offered intervention: (1) report significantly lower consumption; and (2) less unsafe drinking at 9‐month follow‐up. The intensity of intervention was not related to the amount of change in drinking behaviour. Analysis at 10 years failed to find any differences in outcomes between intervention and control groups in median consumption, mean reduction in consumption from baseline to follow‐up, mortality and ICD‐10 diagnoses of alcohol dependence or harmful alcohol use.Conclusions This study failed to find evidence that brief advice and counselling without regular follow‐up and reinforcement can sustain significant long‐term reductions in drinking behaviour at 10‐year follow‐up.
The Benzodiazepine Withdrawal Symptom Questionnaire: psychometric evaluation during a discontinuation program in depressed chronic benzodiazepine users in general practice
Authors: Couvée Jaap E. , Zitman Frans G. 
Published: March 2003

ABSTRACTBackground The Benzodiazepine Withdrawal Symptom Questionnaire (BWSQ, Tyrer et al. 1990) has been developed to measure distinct features of the benzodiazepine withdrawal syndrome. However, psychometric evaluations of this questionnaire are scarce.Aims, setting To evaluate the BWSQ during a discontinuation program carried out by general practitioners in 230 depressed chronic benzodiazepine users.Findings Reliability coefficients during the program were between 0.84 and 0.88 and the test‐retest correlations were between 0.75 and 0.88 during withdrawal. Mean scores of the BWSQ during withdrawal differentiated between completers and failures (p = 0.036). The factor structure underlying the items consisted of perceptual and sensory disturbances, dysphoric mood, muscular pain and memory loss. Low scores during the last phase of tapering off predicted no, or limited, use of benzodiazepines in the first years following discontinuation (p = 0.003).Conclusions We found the BWSQ to measure symptoms during benzodiazepine withdrawal in a reliable way. Our findings indicate some construct validity for BWSQ. Low scores during withdrawal predict more limited future use of benzodiazepines.
The role of functional social support in treatment retention and outcomes among outpatient adult substance abusers
Authors: Dobkin Patricia L. , Civita Mirella De , Paraherakis Antonios , Gill Kathryn 
Published: March 2003

ABSTRACTAims The goals of this study were: (1) to compare patients with high and low functional social support at intake and 6 months later on various risk factors; (2) to test the stress‐buffering role of functional social support on treatment outcomes, and (3) to determine whether levels of functional social support at intake predicted treatment retention.Design Consecutive admissions to an outpatient treatment program were assessed at intake (n = 206) and at 6 month follow‐up (n = 172) using the Addition Severity Index (ASI). Patients completed questionnaires pertaining to social support, stress and psychological functioning both at intake and at 6 months.Findings Both high and low social support groups experienced marked declines in negative affect and in the severity of substance abuse over time. There were some group differences: for example, symptoms of depression and psychological distress were higher among patients with low social support at intake and at 6 months. Patients with low social support at intake reported higher severity of alcohol and drug abuse at 6 months. Hierarchical regression analyses showed that functional social support was a modest predictor of reductions in the severity of alcohol abuse at follow‐up, after controlling for the number of days in treatment. Higher levels of social support explained a modest (6%) proportion of the variance in alcohol‐related outcomes, but did not predict reductions in drug abuse. Survival analysis demonstrated that the rate of dropping out of treatment was significantly higher for patients with low social support.Conclusions Higher functional social support at intake is a positive predictor of retention in treatment, and a modest predictor of reductions in alcohol intake, but not in drug use. Overall, social support accounts for a small percentage of the variance in drug/alcohol‐related outcomes, underscoring the need for further research into variables accounting for treatment success and failure.
Patterns of association between alcohol consumption and symptoms of depression and anxiety in young adults
Authors: Caldwell T. M. , Rodgers B. , Jorm A. F. , Christensen H. , Jacomb P. A. , Korten A. E. , Lynskey M. T. 
Published: March 2003

ABSTRACTAims Recent epidemiological findings indicate that non‐drinkers as well as hazardous/harmful drinkers experience higher levels of distress than moderate drinkers. Little is known about the age at which this develops. This paper examines levels of affect, depression and anxiety over the full range of alcohol consumption in young adults.Design Cross‐sectional findings from the first wave of a prospective, longitudinal study are presented.Participants The general population sample comprised of 2404 young adults (aged 20–24 years), living in the Canberra region. Measures included: the Goldberg Depression and Anxiety scales, the Positive and Negative Affect Schedule, and the Alcohol Use Disorders Identification Test.Findings For men, both non/occasional and hazardous/harmful consumption were associated with lower levels of positive affect and higher levels of anxiety and depression. The higher levels of distress evident for male abstainers were related to being less extroverted and less healthy and not to past hazardous/harmful alcohol consumption, current tobacco or marijuana use. For women, only hazardous/harmful drinkers were found to have higher levels of depression and negative affect. Hazardous/harmful consumption was related to using marijuana, tobacco and recent stressful events in both men and women.Conclusions Higher levels of distress are already evident in male non‐drinkers in early adulthood. The findings counter theories that distress in non‐drinkers is due to past hazardous/harmful alcohol consumption, marijuana or tobacco use, or characteristics in common with hazardous/harmful drinkers. Alcohol use disorders and mental health problems are pertinent issues for young adults. However, more understanding is needed of the experiences of non‐drinkers in an alcohol consuming culture.
Sedative use and misuse in the United States
Authors: Goodwin Renee D. , Hasin Deborah S. 
Published: March 2003

ABSTRACTObjective To determine the prevalence and correlates associated with sedative use and misuse in the general population.Method Data were drawn from the National Comobidity Survey (n = 8098), a representative sample of adults in the community. Multivariate logistic regression analyses were used to identify correlates of sedative use, non‐prescription use and self‐perceived dependence.Results The life‐time prevalence of self‐perceived sedative dependence was 0.5%, 7.1% reported non‐prescribed sedative use and 17.0% had been prescribed sedatives and denied misuse. Individuals who used sedatives without a prescription were more likely to be male (OR = 0.61 (0.44, 0.86)), have lower income (OR = 0.71 (0.54, 0.94)), more education (OR = 1.51 (1.17, 1.96)), major depression (OR = 1.47 (1.04, 2.08)), agoraphobia (OR = 1.59 (1.09, 2.32)), ASPD (OR = 5.29 (3.42, 8.20)) and suicide ideation (OR = 1.91 (1.23, 2.94)), compared with those who did not use sedatives. Individuals with self‐perceived dependence on sedatives were older (OR = 1.05 (1.02, 1.08)), had less education (OR = 0.2 (0.1, 0.7)) and were more likely to have a parent who abused prescription medications (OR = 4.3 (1.03, 18.03)), compared with those without sedative dependence.Conclusions Almost one in 10 adults report misuse of sedatives in their life‐time. Sedative use and misuse are associated with high levels of psychopathology and suicide risk, and show a specific association with parental abuse of prescription medications in the general population. Future work to understand more effectively the nature of these associations may ultimately lead to improved effectiveness of preventive interventions.
Gender differences in help‐utilization and the 8‐year course of alcohol abuse
Authors: Timko Christine , Moos Rudolf H. , Finney John W. , Connell Ellen G. 
Published: March 2003

ABSTRACTAimsThe aim of this study was to compare initially untreated women and men problem drinkers on help‐utilization and outcomes over 8 years.Design and participantsAt the time of the 8‐year follow‐up, individuals (N = 466, 49% female) had self‐selected into four groups: no help, Alcoholics Anonymous (AA) only, formal treatment only or formal treatment plus AA.MeasurementsAt baseline and 1, 3 and 8 years later, participants completed measures of drinking and functioning.FindingsWomen were generally worse off than men on baseline drinking and functioning indices. In keeping with their poorer baseline status, women were more likely to participate in AA, and had longer in‐patient stays during the next year. When women's baseline status was controlled, women had better outcomes than did men at 1 and 8 years. Generally, women and men did not differ on the extent to which obtaining help, or a particular type of help, was related to improved outcomes. Regarding drinking outcomes, women benefited more than did men from more AA attendance during years 2–8 of follow‐up.ConclusionsThe results suggest that although alcoholism interventions were designed primarily for men, they are currently delivered in ways that are also useful to women. Problem‐drinking women appear to benefit from sustained participation in AA, which emphasizes bonding with supportive peers to maintain abstinence.
Educational and occupational attainment and drinking behavior: an expectancy model in young adulthood
Authors: McCarthy Denis M. , Aarons Gregory A. , Brown Sandra A. 
Published: March 2003

ABSTRACTAims The socio‐economic status (SES) variables of education level and occupational functioning have been found to be correlated negatively with alcohol use. The present study examined prospectively the relationship between these functioning measures, alcohol expectancies and alcohol involvement. We propose that expectancies function as a mediator of the relationship between educational/occupational attainment and drinking behavior. We hypothesized that changes in young adult functioning are linked to changes in social context and/or the availability of non‐alcohol reinforcers, which in turn affect the reinforcement expected from alcohol.Participants and design Participants were 172 young adults from an ongoing longitudinal study of long‐term
clinical course of adolescent substance use treatment. Data from 6‐ and 8‐year follow‐ups
were used in the present analyses. The treated sample (n = 100) was recruited
from in‐patient substance abuse treatment programs for adolescents. A community sample
(n = 72) was matched on family history of substance abuse and SES at intake.Findings A cross‐lag panel analysis indicated that education had a unique longitudinal relationship with expectancy for both the treated and community sample, over and above previous alcohol use and expectancy. Occupational variables did not have a longitudinal relationship with alcohol use and expectancy for either sample. Expectancies mediated the education/drinking relationship for the treated sample only.Conclusions These results suggest one means through which changes in functioning may alter alcohol involvement over time: alteration of the reinforcement expected from alcohol.
Process and outcome changes with relapse prevention versus 12‐Step aftercare programs for substance abusers
Authors: Brown Thomas G. , Seraganian Peter , Tremblay Jacques , Annis Helen 
Published: March 2003

ABSTRACTAims Presumptive support was sought for mechanisms of action whereby two conceptually distinct aftercare programs, relapse prevention (RP) and 12‐Step facilitation (TSF), impact upon substance abusers.Patients and design Adults who had just completed intensive treatment were assigned randomly to either
RP (n = 61) or TSF (n = 70) aftercare programs.Setting Three residential treatment facilities.Interventions Trained counselors delivered to small groups a manualized aftercare program which focused either upon the utilization of cognitive–behavioral processes to orchestrate change through an individualized treatment plan (i.e. RP) or which sought to facilitate utilization of AA’s 12 Steps (i.e. TSF).Measurements Process measures developed specifically to quantify either: (a) the changes in self‐efficacy process in RP or (b) the utilization of AA’s principles in TSF, as well as psychosocial and substance abuse indices were administered to all patients pre‐ and post‐aftercare and at 6‐month follow‐up.Findings A significant relationship between changes in measures of self‐ efficacy for RP participants as well as a trend for a relationship between process‐specific change for TSF participants partially satisfied the first condition for presumptive support. The fact that the intervention‐specific mediators covaried with several outcome indices, and that removal of such mediators attenuated prediction of outcome met, respectively, the second and third conditions for presumptive support.Conclusion Carefully orchestrated RP and TSF aftercare programs yield process changes that are related positively to improved outcome.
Effect of a GP desktop resource on smoking cessation activities of general practitioners
Authors: McEwen Andy , Preston Andrew , West Robert 
Published: March 2003

ABSTRACTObjectives To evaluate an intervention aimed at increasing the quantity and quality of brief opportunistic general practitioner (GP) advice to smokers encouraging and supporting quit attempts.Design Randomized controlled trial with two groups: (1) control and (2) GP desktop resource (GDR). Smoking cessation activities of GPs were assessed by an independent postal survey 1 month after distribution of resource.Subjects and setting One hundred and seven GPs in West Dorset.Main outcome measures GPs’ self‐reported rates of advising and counselling smokers on cessation over the previous week.Results The rate of opportunistic advice per week in the GDR group was 4.9 (SD = 4.1), compared with 2.8 (SD = 1.8) in the control group, F = 8.2, p = 0.0025, one‐tailed. The rate of giving counselling was
also higher 2.2 (SD = 3.2) in the intervention group versus 1.0 (SD = 1.4) in the
control group, F = 4.0, p = 0.025, one‐tailed. The proportion who had
recommended or prescribed NRT was greater, although not significantly (54%
versus 46%, Fisher’s exact p = 0.1, one‐tailed).Conclusions The findings indicate that the GDR can increase the rate of delivery of opportunistic advice and provision of counselling. Given the importance of this activity, a larger trial appears to be warranted to examine the long‐term effect and the effect on cessation rates in patients.
Beyond theU‐curve: the relationship between sport and alcohol, cigarette and cannabis use in adolescents
Authors: Peretti‐Watel Patrick , Beck François , Legleye Stéphane 
Published: March 2003

ABSTRACTAimsThis study aimed at increasing understanding of the relationship between sporting activities and alcohol, cigarette and cannabis use among adolescents, by examining gender, age and the context of sporting practice.Design, setting, subjectsThe study was a national school survey (n= 10807; ages 14–19 years) conducted in France in 1999.MeasuresRespondents were asked confidentially by self‐administered questionnaire (pen and paper) about their use of licit and illicit drugs and life‐style (including sporting activities outside school: hours per week, registration in a club, type of sport).FindingsTheU‐shaped curve between the intensity of physical activities and licit and illicit drug use appeared not to be systematic. It depended mainly on the product and the level of use. It only remained significant for boys and heavy smoking once gender and age effect were taken into account.ConclusionThe results stress the need to control for age and gender when the survey participants are teenagers. The relationship between drug use and sporting activity also depends on the type of sport.
Illicit drug initiation among institutionalized drug users in China
Authors: Li Xiaoming , Zhou Yong , Stanton Bonita 
Published: March 2003

ABSTRACTAims To examine the circumstances and correlates associated with initiation of illicit drug use among institutionalized drug users in China.Design Cross‐sectional, retrospective study.Settings Six compulsory drug cessation programs in Yunnan Province and Gunagxi Zhuang Autonomous Region of China.Participants A gender‐stratified random sample of 833 drug users (88% males and 12% females) enrolled in compulsory drug cessation programs in November 1996.Measurements Circumstances of illicit drug initiation (age, type of drugs, routes of drug administration, social setting, source of drugs, reasons for drug use), the risk behaviors and risk perceptions prior to drug initiation.Findings The majority of participants initiated drug use with heroin (90%). Initial drugs were frequently administered through sniffing/snorting (55%) and smoking cigarettes mixed with a drug (38%). First drug use occurred most commonly at a friend’s home (65%) and in the company of other drug users (83%). Drugs were generally provided free for first‐time use by other drug users (72%). Reasons for first drug use included experimentation (90%), being lured into drugs by other people (44%) and relaxation (42%). Most drug users had a history of regular cigarette smoking (89%), alcohol consumption (49%) and deviant behaviors (51%) prior to their drug initiation. The majority perceived that their friends (90%) and neighbors (88%) used illicit drugs.Conclusions The findings are similar to studies in western countries with respect to the pattern and correlates of illicit drug initiation, and underscore the need for drug prevention efforts in China.
Treatment of out‐patients with complicated benzodiazepine dependence: comparison of two approaches
Authors: Vorma Helena , Naukkarinen Hannu , Sarna Seppo , Kuoppasalmi Kimmo 
Published: March 2003

ABSTRACTAimsTo evaluate whether gradual benzodiazepine taper combined with cognitive‐behavioural treatment is more effective than standard treatment for patients with dependence in out‐patient clinics.DesignA randomized, controlled clinical trial, using standard questionnaires and serum and urine tests.SettingsFour public‐sector out‐patient clinics for alcohol and drug abusers in Helsinki.ParticipantsSeventy‐six patients with benzodiazepine dependence (DSM‐III‐R). Patients taking high doses of the drug or with alcohol use disorders were included to obtain a subject group representative of usual clinical practice.InterventionSubjects received gradual benzodiazepine taper combined with cognitive‐behavioural therapy (experimental group) or standard withdrawal treatment not scheduled by the researchers (control group).MeasurementsThe outcome was measured in terms of attaining a state of abstinence or by a decrease in the dosage during the study period of up to 12 months’ duration.FindingsNo statistically significant differences in the outcomes were observed between the groups. A total of 13% of the experimental group and 27% of the control group were able to discontinue drug use. In addition 67% of the experimental group and 57% of the control group were able to decrease the dose.ConclusionsThe search continues for improved methods of helping patients with complicated benzodiazepine dependence.