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Neurofeedback in Combination with Psychotherapy
Published in Hanno W. Kirk, Restoring the Brain, 2020
People with anxiety disorders are up to three times more likely to suffer an alcohol or other substance abuse disorder than those without an anxiety disorder. Studies have shown that problem drinking is more prevalent in patients with anxiety disorders. Because the suffering with these disorders is substantial, anxiety disorders should not go untreated. An additional problem is that long-term alcohol abuse usually means building a tolerance to its effects. This results in increased alcohol consumption to get the desired result. Therefore, what begins as a way to cope with anxiety can quickly have the opposite effect of increasing anxiety. Problem drinking leads to alcohol withdrawal, known as a “hangover.” The symptoms of alcohol withdrawal include anxiety and panic attacks, besides other possible symptoms such as agitation, nausea, vomiting, elevated blood pressure, elevated heart rate, and increased body temperature. These symptoms tend to create a cycle of heightened anxiety and increased problem drinking.42,43,44
Answers
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Alcoholism is where someone’s drinking leads to harm in their work or social lives. It pervades all layers of society and can manifest itself as binge drinking or regular high daily intakes. Other psychiatric diagnoses may be present and denial is a feature, so collateral history taking is important. Long-term physical effects include hepatitis, liver cirrhosis, cognitive deficits, peptic ulcers and anaemia. Withdrawal from alcohol can occur if there is a period of abstinence following long-term alcohol consumption. Signs include tremor, autonomic instability, confusion, seizures and hallucinations. This can be treated with a weaning dose of benzodiazepine medication. Long-term alcohol abuse can be treated with self-help, group therapy and developing strategies to avoid situations where alcohol can be consumed. Medications such as disulfuram act by causing severe unpleasant side effects in small ingestions of alcohol and should be used with caution.
Pre- and Perinatal Factors in the Etiology of Mental Retardation
Published in Michele Kiely, Reproductive and Perinatal Epidemiology, 2019
However, methodological problems abound. The syndrome is often incomplete, and there is some evidence that very similar combinations of features may occur without alcohol, with other agents such as phenytoin, and in maternal phenylketonuria.115 Smithells and Smith18 have questioned whether the term is appropriate, though they had no doubt of the deleterious effects, and their importance in mental retardation. Certainly definitions of outcome are problematic, but much more so are measurements of alcohol consumption, depending, as they usually do, on patient interviews, and taking account, as they must, of different and varying patterns of drinking. It also seems likely that many clinicians still do not seriously enquire for it. Moreover, alcohol abuse may be associated with many other environmental, social, and particularly behavioral factors which are difficult to record, measure, and assess. High alcohol consumption may also provoke nutritional inadequacies, or interact with other drugs, and is likely to show considerable individual variation in effect.
Hepatocellular carcinoma in Stockholm, Sweden 2003–2018: a population-based cohort study
Published in Scandinavian Journal of Gastroenterology, 2022
Sanna Norén, Bonnie Bengtsson, Hannes Hagström, Gunnar Ljunggren, Staffan Wahlin
ICD-10 codes for comorbidities present at or before HCC diagnosis were collected for each patient with HCC to identify underlying aetiologies of HCC. Definitions of specific risk factors for HCC and ICD-10 codes used to identify these are presented in Supplementary Table 1. Every patient was only attributed one risk factor, according to a ranking system of risk factors for HCC presented in Supplementary Table 1, and each patient is therefore only included once. Primary liver disease, such as primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and Budd-Chiari syndrome was given the highest rank, followed by Hepatitis B and then Hepatitis C, which included unspecified chronic viral hepatitis. The underlying aetiology was defined as alcohol-related liver disease (ARLD) if an individual had either (a) an ICD-10 diagnosis of ARLD or (b) a diagnosis of alcohol abuse, and (c) no other liver diagnosis. The underlying aetiology was defined as non-alcoholic fatty liver disease (NAFLD) if no other aetiologies were identified and the patient had either (a) a diagnosis of fatty liver disease, (b) diabetes mellitus, (c) treatment for diabetes mellitus, (d) obesity, or (e) hyperlipidaemia. Individuals were classified as having cryptogenic cirrhosis if they had the code for cirrhosis (ICD-10 K74.6) but no other identified risk factor or liver disease.
Religiosity as a mediating factor in alcohol use and alcohol related problems among students attending a historically black college (HBCU)
Published in Journal of Ethnicity in Substance Abuse, 2022
Anisah Bagasra, Kurt Holzhausen, Mitchell B. Mackinem
The questionnaires were composed of two demographic questions (age and gender) and four standard, validated research instruments, two that measured alcohol consumption and alcohol-related problems and two that measured religiosity. There was a total of thirty-four questions for the entire questionnaire. Among the many instruments available the researchers sought to use only validated instruments to increase validity and reliability. Shorter, rather than longer, instruments were favored to increase the response rate as the effort is less as compared to extensive research instruments. The Alcohol Use Disorders Identification Test (AUDIT) is a 10 item scale developed to aid in the early detection of alcohol use disorders. Questions assess how often the individual consumes alcohol at harmful levels and exhibits symptoms of alcohol abuse such as failing to meet expectations due to drinking, drinking in the morning, experiencing blackouts, etc. One question each concerns emotional and social symptoms and so overlaps with subscales of the CAPS-r described below. Total scores range from 0 to 40, with high scores indicating more frequent problematic behavior. A score of 8 or more is associated with harmful or hazardous drinking, a score of 13 or more in women, and 15 or more in men, is likely to indicate alcohol dependence (Saunders, Aasland, Babor, de la Fuente, & Grant, 1993).
Zieve syndrome in acute alcoholic hepatitis
Published in Baylor University Medical Center Proceedings, 2020
Ted George Achufusi, Jasmine Sandhu, Japjot Chahal, Zachary Shepherd, Kanish Mirchia
Although Zieve syndrome is considered rare, many believe that it is more common than previously reported. Some studies estimate the incidence to be 1 in 1600 admissions.1,5 The disease is often misdiagnosed in favor of acute abdomen, as symptoms and laboratory results often overlap, leading to unnecessary surgical procedures. The diagnosis in this case was established based on a history of alcohol abuse and other pertinent physical examination and laboratory findings. This patient had an extensive history of alcohol abuse and displayed the triad of anemia, jaundice, and hyperlipidemia. Her lab work also supported the diagnosis. The peripheral blood smear showed evidence of hemolysis with schistocytes, and the bone marrow biopsy demonstrated reticulocytosis (Figure 1). Furthermore, the combination of transient hyperlipidemia and a negative Coombs test supported the diagnosis of Coombs test–negative hemolytic anemia. Based on these findings, the diagnosis of Zieve syndrome was established.