Monthly Archives: October 2014

Disentangling Alcohol-Related Needs Among Pre-trial Prisoners: A Longitudinal Study

  1. Anna Kissell1,*,
  2. Pamela J. Taylor1,*,
  3. Julian Walker2,3,
  4. Emma Lewis4,
  5. Amy Hammond5 and
  6. Tim Amos2,3
  1. 1Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
  2. 2West of England Forensic Mental Health Services, Bristol, UK
  3. 3Centre for Academic Mental Health, Bristol University, Bristol, UK
  4. 4Research and Development Office, Cardiff and Vale University, Local Health Board, Cardiff, UK
  5. 5South London and South East Hub, Mental Health Research Network, London, UK
  1. *Corresponding author: Institute of Psychological Medicine and Clinical Neurosciences, 2nd Floor Hadyn Ellis building, Maindy Road, Cardiff CF24 4HQ, UK. Tel.: +44-02920-688352; E-mail: kissellae{at}cardiff.ac.uk
  • Received February 25, 2014.
  • Revision requested July 24, 2014.
  • Revision received July 28, 2014.
  • Accepted July 29, 2014.

Aims: To disentangle the alcohol-related needs of short stay, revolving door, male prisoners, and offer a theoretically driven but practical approach for allocation of scarce service resources. Methods: A prospective longitudinal interview, questionnaire and records study of pre-trial men newly imprisoned in Wales and SW England. Results: Two hundred and forty-one pre-trial men completed an interview and questionnaires within a week of a new reception into prison; 170 completed follow-up 3 weeks later. Questions about problems with alcohol or illicit drugs revealed that problem drinkers were less likely than problem drug users to recognize their difficulty or seek or get help for this during their first month of imprisonment. Co-morbidity was common, but a third of the men had alcohol problems alone. Use of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire identified 80% (195/241) men likely to require some intervention, twice the number identified by direct questions relying on prisoners' judgment about problem use. Furthermore it allowed categorization according to likely risk (dependency), need (problem recognition) and responsivity (wish for help). Conclusion: Alcohol misuse is recognized, worldwide, as fuelling crime and more common among prisoners than the general population. In England and Wales, it is a particular factor in brief but recurrent periods of imprisonment. There have been calls to pay more attention to its use in this context, albeit without any increase in resources. Adding two questions to standard screening enables application of the risk-need-responsivity model to problem drinkers and may identify those most likely to benefit from treatment.

Alcoholic Ketosis: Prevalence, Determinants, and Ketohepatitis in Japanese Alcoholic Men

  1. Akira Yokoyama1,*,
  2. Tetsuji Yokoyama2,
  3. Takeshi Mizukami1,
  4. Toshifumi Matsui1,3,
  5. Koichi Shiraishi4,
  6. Mitsuru Kimura1,
  7. Sachio Matsushita1,
  8. Susumu Higuchi1 and
  9. Katsuya Maruyama1
  1. 1National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan
  2. 2Department of Health Promotion, National Institute of Public Health, Saitama 351-0104, Japan
  3. 3Department of Geriatric Medicine, Kyorin University Hospital, Tokyo 181-8611, Japan
  4. 4Department of Gastroenterology, Tokai University School of Medicine, Kanagawa 259-1193, Japan
  1. *Corresponding author: National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa 239-0841, Japan. Tel.: +81-46-848-1550; Fax: +81-46-849-7743; E-mail: a_yokoyama{at}kurihama1.hosp.go.jp
  • Received April 9, 2014.
  • Revision requested May 27, 2014.
  • Revision received June 9, 2014.
  • Accepted July 3, 2014.

Aims: Alcoholic ketosis and ketoacidosis are metabolic abnormalities often diagnosed in alcoholics in emergency departments. We attempted to identify determinants or factors associated with alcoholic ketosis. Methods: The subjects of this cross-sectional survey were 1588 Japanese alcoholic men (≥40 years) who came to an addiction center within 14 days of their last drink. Results: The results of the dipstick urinalyses revealed a prevalence of ketosis of 34.0% (±, 21.5%; +, 8.9%; and 2+/3+; 3.6%) in the alcoholics. Higher urine ketone levels were associated with higher serum total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyl transpeptidase levels. A multivariate analysis by the proportional odds model showed that the odds ratio (95% confidence interval) for an increase in ketosis by one category was 0.94 (0.84–1.06) per 10-year increase in age, 0.93 (0.89–0.97) per 1-day increase in interval since the last drink, 1.78 (1.41–2.26) in the presence of slow-metabolizing alcohol dehydrogenase-1B (ADH1B*1/*1), 1.61 (1.10–2.36) and 1.30 (1.03–1.65) when the beverage of choice was whiskey and shochu, respectively (distilled no-carbohydrate beverages vs. the other beverages), 2.05 (1.27–3.32) in the presence of hypoglycemia <80 mg/dl, 0.91 (0.88–0.94) per 1-kg/m2 increase in body mass index (BMI), 1.09 (1.00–1.18) per +10 cigarettes smoked, and 2.78 (2.05–3.75) when the serum total bilirubin level was ≥2.0 mg/dl, and 1.97 (1.47–2.66) when the serum AST level was ≥200 IU/l. Conclusion: Ketosis was a very common complication and frequently accompanied by alcoholic liver injury in our Japanese male alcoholic population, in which ADH1B*1/*1 genotype, consumption of whiskey or shochu, hypoglycemia, lower BMI and smoking were significant determinants of the development of ketosis.

Prenatal Ethanol Exposure Up-Regulates the Cholesterol Transporters ATP-Binding Cassette A1 and G1 and Reduces Cholesterol Levels in the Developing Rat Brain

  1. Chunyan Zhou1,
  2. Jing Chen1,
  3. Xiaolu Zhang2,3,
  4. Lucio G. Costa1,4 and
  5. Marina Guizzetti1,2,3,*
  1. 1Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
  2. 2Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
  3. 3Jesse Brown VA Medical Center, Chicago, IL, USA
  4. 4Department of Neuroscience, University of Parma, Parma, Italy
  1. *Corresponding author: Jesse Brown VA Medical Center, Research and Development Section, 820 South Damen Avenue, Chicago, IL 60612, USA. Tel.: +1-312-569-8684; E-mail: mguizzetti{at}psych.uic.edu
  • Received October 15, 2013.
  • Revision requested November 7, 2013.
  • Revision received May 11, 2014.
  • Accepted June 17, 2014.

Aims: Cholesterol plays a pivotal role in many aspects of brain development; reduced cholesterol levels during brain development, as a consequence of genetic defects in cholesterol biosynthesis, leads to severe brain damage, including microcephaly and mental retardation, both of which are also hallmarks of the fetal alcohol syndrome. We had previously shown that ethanol up-regulates the levels of two cholesterol transporters, ABCA1 (ATP binding cassette-A1) and ABCG1, leading to increased cholesterol efflux and decreased cholesterol content in astrocytes in vitro. In the present study we investigated whether similar effects could be seen in vivo. Methods: Pregnant Sprague-Dawley rats were fed liquid diets containing 36% of the calories from ethanol from gestational day (GD) 6 to GD 21. A pair-fed control groups and an ad libitum control group were included in the study. ABCA1 and ABCG1 protein expression and cholesterol and phospholipid levels were measured in the neocortex of female and male fetuses at GD 21. Results: Body weights were decreased in female fetuses as a consequence of ethanol treatments. ABCA1 and ABCG1 protein levels were increased, and cholesterol levels were decreased, in the neocortex of ethanol-exposed female, but not male, fetuses. Levels of phospholipids were unchanged. Control female fetuses fed ad libitum displayed an up-regulation of ABCA1 and a decrease in cholesterol content compared with pair-fed controls, suggesting that a compensatory up-regulation of cholesterol levels may occur during food restriction. Conclusion: Maternal ethanol consumption may affect fetal brain development by increasing cholesterol transporters’ expression and reducing brain cholesterol levels.

Sports and Spirits: A Systematic Qualitative Review of Emergent Theories for Student-Athlete Drinking

  1. Jin Zhou* and
  2. Derek Heim
  1. Department of Psychology, Edge Hill University, Ormskirk, UK
  1. *Corresponding author: Department of Psychology, Edge Hill University, Ormskirk L39 4QP, UK. Tel.: +44-1695-584522; E-mail: zhoujn{at}edgehill.ac.uk
  • Received June 2, 2014.
  • Revision requested June 26, 2014.
  • Revision received August 11, 2014.
  • Accepted August 17, 2014.

Aims: To review the current literature and critically examine theories used to explain the link between athletic status and hazardous alcohol consumption, and highlight emergent perspectives. Methods: A search of online databases (Google Scholar, PubMed, ScienceDirect, PsychINFO) and a systematic methodology were used to identify relevant studies for inclusion. Sixty-six articles were included for review (publishing dates ranging from 1989 to 2013). Results: The majority of the studies were from the USA (n = 52), with cross-sectional surveys the most utilized method of data collection. The literature outlines a number of important sport-specific factors that may be motivating drinking behaviour among student athletes. Moreover, social processes appear particularly important for sport-associated drinking. However there is still paucity in the theoretical underpinnings for this relationship, and the processes through which membership of a sports group may shape its members drinking. The role of identity emerged as an important variable to consider when exploring engagement of health behaviours, such as alcohol consumption. Conclusions: With the aim of reducing alcohol-related harm, the impact of sports group membership on psychosocial variables such as social identity and well-being warrants further exploration. Future research should explore the role of identity and group-level processes when examining the engagement of drinking behaviours of student sportspeople.

Are Carbohydrate-Deficient Transferrin Assays Useful for the Detection of Recurrent ‘Binge Drinking’ in Children with an Alcohol Intoxication in the Emergency Department?

  1. Margot A.L. Stokbroekx1,
  2. Saskia Houterman2,
  3. Stefan A.J. Coolen3,
  4. Nico van der Lely4 and
  5. Rolf A.A. Pelleboer1,*
  1. 1Department of Paediatrics, Catharina Hospital, Eindhoven, the Netherlands
  2. 2Department of Education and Research, Catharina Hospital, Eindhoven, the Netherlands
  3. 3Medical Laboratories, Department of Clinical Chemistry, Reinier de Graaf Hospital, Delft, the Netherlands
  4. 4Department of Paediatrics, Reinier de Graaf Hospital, Delft, the Netherlands
  1. *Corresponding author: Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, the Netherlands. Tel.: +31-40-239-92-00; E-mail: r.pelleboer{at}onsnet.nu
  • Received February 5, 2014.
  • Revision requested March 18, 2014.
  • Revision received May 13, 2014.
  • Accepted July 7, 2014.

Aims: The aim of this study was to evaluate different carbohydrate-deficient transferrin (CDT) assays for the detection of recurrent excessive alcohol abuse in adolescents prior to acute alcohol intoxication. Methods: Data on drinking behaviour and CDT levels of adolescents (13–18 years) registered at the outpatient clinic for youth and alcohol at three major district general hospitals in the Netherlands were retrospectively collected. CDT and disialotransferrin (DST) levels of binge-drinking teenagers were compared with non-binge-drinking teenagers. Results: In total 198 samples were collected for the N Latex CDT method (N = 83), no differences were found in mean CDT levels for binge versus non-binge drinkers (P = 0.8). The Helander HPLC (N = 78) showed significantly higher values for binge drinkers than for non-binge drinkers (mean 1.20%DST, SD 0.28 and mean 1.01%DST, SD 0.31, respectively (P = 0.01)). The Recipe ClinRep method (N = 37) also showed significantly higher values for binge drinkers (mean 1.17%DST, SD 0.36 and mean 0.89%DST, SD 0.34, respectively (P = 0.03)). Conclusion: With the Helander HPLC method and the Recipe ClinRep assay higher levels are measured in binge drinkers than in non-binge drinkers.

Cheap alcohol and Declan’s death

  1. Jonathan Chick
  1. Chief Editor jonathan.chick{at}gmail.com

Declan died before he reached age two. His mummified body was found in his mother's home in Renfrewshire, Scotland. His mother's murder conviction in 2011 was quashed on Appeal in 2013 on the grounds that pathologists had been unable to give a cause of death for the toddler.

Findings of a Fatal Accident Enquiry were published on 5 September 2014 (www.scotland-judiciary.org.uk/10/1308). It was revealed that Declan's mother had ‘a long history of drug and alcohol abuse’. Neighbours knew that she left the baby at home for long periods crying when she ‘visited neighbouring houses to drink’.

The primary care services had evidence of ‘regular excessive drinking’ but it seems the general practitioner was constrained in taking further action unless the patient was deemed ‘dependent’ on alcohol. …