scholarly journals The Clinical Course of Alcohol Use Disorder Depicted by Digital Biomarkers

2021 ◽  
Vol 3 ◽  
Author(s):  
Andreas Zetterström ◽  
Markku D. Hämäläinen ◽  
Maria Winkvist ◽  
Marcus Söderquist ◽  
Patrik Öhagen ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Clinical Decision Making ◽  
Treatment Time ◽  
Clinical Course ◽  
Digital Health ◽  
Current Trend ◽  
Drinking Patterns ◽  
Starting Point ◽  
Digital Biomarkers

Aims: This study introduces new digital biomarkers to be used as precise, objective tools to measure and describe the clinical course of patients with alcohol use disorder (AUD).Methods: An algorithm is outlined for the calculation of a new digital biomarker, the recovery and exacerbation index (REI), which describes the current trend in a patient's clinical course of AUD. A threshold applied to the REI identifies the starting point and the length of an exacerbation event (EE). The disease patterns and periodicity are described by the number, length, and distance between EEs. The algorithms were tested on data from patients from previous clinical trials (n = 51) and clinical practice (n = 1,717).Results: Our study indicates that the digital biomarker-based description of the clinical course of AUD might be superior to the traditional self-reported relapse/remission concept and conventional biomarkers due to higher data quality (alcohol measured) and time resolution. We found that EEs and the REI introduce distinct tools to identify qualitative and quantitative differences in drinking patterns (drinks per drinking day, phosphatidyl ethanol levels, weekday and holiday patterns) and effect of treatment time.Conclusions: This study indicates that the disease state—level, trend and periodicity—can be mathematically described and visualized with digital biomarkers, thereby improving knowledge about the clinical course of AUD and enabling clinical decision-making and adaptive care. The algorithms provide a basis for machine-learning-driven research that might also be applied for other disorders where daily data are available from digital health systems.

scholarly journals Comorbid Bipolar and Alcohol Use Disorder—A Therapeutic Challenge

2021 ◽  
Vol 12 ◽  
Author(s):  
Heinz Grunze ◽  
Martin Schaefer ◽  
Harald Scherk ◽  
Christoph Born ◽  
Ulrich W. Preuss
Keyword(s):  
Bipolar Disorder ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Integrated Treatment ◽  
Drinking Patterns ◽  
Integrated Therapy ◽  
The Family ◽  
Male Preponderance ◽  
Complicated Course ◽  
Treatment Concepts

Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40–70%, both for Bipolar I and II disorder, and with male preponderance. Alcohol use disorder and bipolarity significantly influence each other's severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity.

Predicting persistency of DSM-5 alcohol use disorder and examining drinking patterns of recently remitted individuals: a prospective general population study

Addiction ◽  
2013 ◽  
Vol 108 (12) ◽  
pp. 2091-2099 ◽  
Author(s):  
Marlous Tuithof ◽  
Margreet ten Have ◽  
Wim van den Brink ◽  
Wilma Vollebergh ◽  
Ron de Graaf
Keyword(s):  
Alcohol Use ◽  
General Population ◽  
Population Study ◽  
Alcohol Use Disorder ◽  
Drinking Patterns ◽  
General Population Study ◽  
Dsm 5

scholarly journals Interaction of Heavy Drinking Patterns and Depression Severity predicts Efficacy of Quetiapine Fumarate XR in lowering Alcohol Intake in Alcohol Use Disorder Patients

2020 ◽  
Author(s):  
Vatsalya Vatsalya ◽  
Maiying Kong ◽  
Luis M. Marsano ◽  
Zimple D Kurlawala ◽  
Kan V Chandras ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Rating Scale ◽  
Heavy Drinking ◽  
Depression Symptoms ◽  
Drinking Patterns ◽  
Quetiapine Fumarate ◽  
Heavy Alcohol ◽  
Depression Ratings

Background: Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression. We investigated the role of depression ratings and patterns of heavy drinking on the treatment efficacy of Quetiapine fumarate XR in lowering alcohol intake in alcohol use disorder (AUD) patients. Methods: One hundred and eight male and female heavy drinking AUD patients in the age range of 18 to 64 yrs. received 12 weeks of active treatment. Participants were grouped by the severity grading of depression using Montgomery Asberg Depression Rating Scale (MADRS) (clinically relevant≥8 [CR], clinically non-relevant≤7 [CNR]) at baseline. Drinking history and depression ratings were assessed at the patients visits. Results: Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD and AvgD) and MADRS scores by the end of the treatment course. Conclusions: Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR.

scholarly journals Alcohol Use Disorder in a Culture That Normalizes the Consumption of Alcoholic Beverages: The Conflicts for Decision-Making

2020 ◽  
pp. 163-170
Author(s):  
Guilherme Messas ◽  
Maria Julia Soares
Keyword(s):  
Decision Making ◽  
Alcohol Use ◽  
Cultural Values ◽  
Alcohol Use Disorder ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Alcoholic Beverages ◽  
Shared Decision ◽  
Brazilian Culture ◽  
The Impact

AbstractValue-Based Practice (VBP) allows individual and cultural values to be important elements in clinical decision-making. The following chapter exemplifies the application of this approach to a patient with an alcohol use disorder within the Brazilian culture, a culture that minimizes the impact of alcohol consumption on health. By applying principles such as shared decision-making and basing choices on evidence and values, the patient increased the adherence and, consequently, the effectiveness of the proposed treatment.

scholarly journals Patterns Of Alcohol Consumption Data Over 21 Years Following Hospitalization For Alcohol Use Disorder

2020 ◽  
Vol 7 (4) ◽  
pp. 1-9
Author(s):  
Collins E Lewis ◽  
Keyword(s):  
Chronic Disease ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Psychiatric Hospitalization ◽  
Disease Process ◽  
Drinking Patterns ◽  
Drinking Alcohol ◽  
Problematic Drinking ◽  
Consumption Data ◽  
The Stability

Alcohol use disorder is a chronic disease, and the consumption of alcohol after treatment is an integral part of the disease process. However, drinking alcohol itself is not a disorder; persistent problematic drinking is. This paper assesses the stability of the yearly drinking patterns of individuals with alcohol use disorder after discharge from psychiatric hospitalization for Alcohol Use Disorder (AUD).

scholarly journals Interaction of Heavy Drinking Patterns and Depression Severity Predicts Efficacy of Quetiapine Fumarate XR in Lowering Alcohol Intake in Alcohol Use Disorder Patients

2020 ◽  
Vol 14 ◽  
pp. 117822182095518
Author(s):  
Vatsalya Vatsalya ◽  
Maiying Kong ◽  
Luis M Marsano ◽  
Zimple Kurlawala ◽  
Kan V Chandras ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Rating Scale ◽  
Heavy Drinking ◽  
Depression Symptoms ◽  
Drinking Patterns ◽  
Quetiapine Fumarate ◽  
Heavy Alcohol ◽  
Depression Ratings

Background: Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression. We investigated the treatment efficacy of Quetiapine fumarate extended release (XR) in lowering alcohol intake in alcohol use disorder (AUD) patients indicated by the shared alleviation of depression ratings and patterns of heavy drinking. Methods: Hundred and eight male and female heavy drinking AUD patients in the age range of 18 to 64 years. participated in a randomized clinical trial (RCT) to receive 12 weeks of quetiapine XR or placebo (N = 115). Participants were sub-grouped by the severity grading of depression using Montgomery-Asberg Depression Rating Scale (MADRS) (clinically relevant ⩾8 [CR], clinically non-relevant ⩽7 [CNR]) at baseline in both the groups. Drinking history and depression ratings were assessed at the patients’ visits. Results: Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD, and AvgD) and MADRS scores by the end of the treatment course. Conclusions: Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR. ClinicalTrials.gov: NCT#0049862 ( https://clinicaltrials.gov/ct2/show/NCT00498628?term=litten&draw=2&rank=3 )

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