Alcohol (Hanover, York County, Pa.)最新文献_第4页

Alcohol consumption reported on routine healthcare screenings is associated with all-cause mortality in primary care patients: A retrospective cohort study 一项回顾性队列研究：在初级保健患者中，常规保健筛查中报告的饮酒与全因死亡率相关。

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-12-02 DOI: 10.1111/acer.70192

Theresa E. Matson, Jennifer F. Bobb, Malia Oliver, Douglas B. Berger, Helen E. Jack, Tessa L. Steel, Katharine A. Bradley, Kevin A. Hallgren

Background

Associations between alcohol and mortality are well documented in epidemiological studies, but whether brief alcohol screening measures administered routinely in primary care similarly predict mortality is less established. This study examined whether alcohol consumption reported on the three-item Alcohol Use Disorder Identification Test, Consumption (AUDIT-C) during routine care was associated with all-cause mortality, and secondarily, whether age and sex modified associations.

Methods

This retrospective cohort study used electronic health record data from a large integrated health system and death data from the Washington Department of Health. Adult (≥18 years) primary care patients were included if they completed an AUDIT-C screen (March 1, 2015–December 31, 2021). AUDIT-C scores were categorized: no alcohol use (0), low-risk alcohol use (1–2 female/1–3 male), moderate-risk alcohol use (3–6 female/4–6 male), high-risk alcohol use (7–8), or very high-risk alcohol use (9–12). Time-to-event (death or censoring) was measured for up to 8 years (2015–2023). Cox proportional hazards models, adjusted for demographic and clinical covariates, estimated adjusted all-cause mortality across AUDIT-C score categories, with low-risk alcohol use as the reference.

Results

Among 531,851 primary care patients, a majority were aged 30–59 (52%), female (58%), non-Hispanic (94%), and White (70%). A total of 21,548 patients died (4.8%) during follow-up (median 1752 days). Compared to patients reporting low-risk alcohol use, those reporting no use or very high-risk use had higher mortality (hazard ratio [HR] = 1.40 [95% CI: 1.36–1.44] and HR = 1.58 [1.35–1.84], respectively); those with moderate-risk use had lower mortality (HR = 0.86 [0.83–0.90]). Associations varied by age (stronger among young adults) but not sex.

Conclusions

Alcohol use reported on brief screens during routine primary care had an approximately convex association (J- or U-shaped depending on sub-population) with all-cause mortality as observed in prior epidemiological studies. Findings support the value of routine alcohol screening as a tool for identifying patients at risk for major adverse health outcomes like death.

背景：流行病学研究充分证明了酒精与死亡率之间的关系，但初级保健中常规实施的简短酒精筛查措施是否同样能预测死亡率尚不确定。本研究调查了三项酒精使用障碍识别测试中报告的酒精消费量，常规护理期间的消费量（AUDIT-C）是否与全因死亡率相关，其次，年龄和性别是否改变了相关性。方法：这项回顾性队列研究使用了来自大型综合卫生系统的电子健康记录数据和来自华盛顿卫生部的死亡数据。成年（≥18岁）初级保健患者如果完成了AUDIT-C筛查（2015年3月1日- 2021年12月31日），则纳入。AUDIT-C得分分为：无酒精使用（0分）、低风险酒精使用（1-2名女性/1-3名男性）、中度风险酒精使用（3-6名女性/4-6名男性）、高风险酒精使用（7-8分）或非常高风险酒精使用（9-12分）。事件（死亡或审查）发生的时间最长为8年（2015-2023年）。Cox比例风险模型，调整了人口统计学和临床协变量，以低风险饮酒为参考，估计了AUDIT-C评分类别中调整后的全因死亡率。结果：在531,851名初级保健患者中，大多数年龄在30-59岁（52%），女性（58%），非西班牙裔（94%）和白人（70%）。在随访期间（中位1752天），共有21548例患者死亡（4.8%）。与报告低风险饮酒的患者相比，报告不饮酒或非常高风险饮酒的患者死亡率更高（风险比[HR] = 1.40 [95% CI: 1.36-1.44]和HR = 1.58 [1.35-1.84]）；中危用药组死亡率较低（HR = 0.86[0.83-0.90]）。这种关联因年龄而异（在年轻人中更为明显），但与性别无关。结论：在之前的流行病学研究中观察到，在常规初级保健期间的简短筛查中报告的酒精使用与全因死亡率呈近似凸相关性（J型或u型，取决于亚人群）。研究结果支持常规酒精筛查作为识别有死亡等主要不良健康结果风险的患者的工具的价值。

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引用次数: 0

Age-related impact of outcomes in hospitalized patients with alcohol overuse 酒精过度使用住院患者预后的年龄相关影响

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-12-01 DOI: 10.1111/acer.70219

Dhweeja Dasarathy, Amy H. Attaway

Background

The incidence of alcohol use disorder (AUD) and related complications, such as alcohol-associated liver disease and alcohol-associated cirrhosis, continues to rise in the United States. However, limited data exist on the impact of AUD in aging hospitalized populations. We aimed to evaluate the association between AUD and clinical outcomes in aging hospitalized patients.

Methods

We analyzed 2017–2020 data from the Nationwide Inpatient Sample, including adults aged 18–80 with and without AUD based on ICD-10 codes (AUD: n = 523,464; general medical population [GMP]: n = 238,678). Primary outcomes included length of stay, discharge disposition, healthcare cost, mortality, sarcopenia, and frailty. Multivariable regression analyses were conducted within and across age strata (<50, 50–60, 61–70, 71–80 years).

Results

Compared to the GMP, patients with AUD had higher healthcare utilization and more comorbidities across all age groups. A higher proportion of females were diagnosed with AUD in each age category. The prevalence of sarcopenia and frailty increased with age, with the highest rates in AUD patients over 70. Across all age groups, AUD was independently associated with worse outcomes, including increased sarcopenia, frailty, healthcare costs, longer hospital stays, and worse discharge dispositions. Mortality risk was elevated in AUD patients under 70 (odds ratios: 1.55, 1.41, 1.21 for <50, 50–60, 61–70, respectively), but not in those over 70 (OR: 0.95), suggesting survivor bias. Concurrent sarcopenia and frailty conferred greater mortality risk than either alone.

Conclusions

AUD is independently associated with worse clinical outcomes in hospitalized adults, especially older adults. These findings underscore the urgent need for age-tailored alcohol intervention strategies.

背景：在美国，酒精使用障碍（AUD）和相关并发症（如酒精相关性肝病和酒精相关性肝硬化）的发病率持续上升。然而，关于老年住院人群AUD影响的数据有限。我们的目的是评估老年住院患者的AUD与临床结果之间的关系。方法：我们根据ICD-10代码分析了2017-2020年全国住院患者样本的数据，包括18-80岁有和没有AUD的成年人（AUD: n = 523,464；一般医疗人群[GMP]: n = 238,678）。主要结局包括住院时间、出院处置、医疗费用、死亡率、肌肉减少症和虚弱。结果：与GMP相比，所有年龄组的AUD患者都有更高的医疗保健利用率和更多的合并症。在每个年龄组中，女性被诊断为AUD的比例较高。肌肉减少症和虚弱的患病率随着年龄的增长而增加，70岁以上AUD患者的患病率最高。在所有年龄组中，AUD与较差的结果独立相关，包括增加的肌肉减少症、虚弱、医疗费用、较长的住院时间和较差的出院处置。70岁以下AUD患者的死亡风险升高（优势比：1.55,1.41,1.21）。结论：住院成人，尤其是老年人，AUD与较差的临床结果独立相关。这些发现强调了针对年龄的酒精干预策略的迫切需要。

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引用次数: 0

Impact of ALDH2 genotypes and alcohol consumption on age at first-ever ischemic stroke: A cohort study in Taiwan ALDH2基因型和饮酒对首次缺血性脑卒中年龄的影响：台湾的一项队列研究。

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-12-01 DOI: 10.1111/acer.70217

Yueh-Feng Sung, Jiunn-Tay Lee, Chaur-Jong Hu, Jiann-Shing Jeng, Hung-Yi Chiou, Giia-Sheun Peng

Background

The ALDH2*2 allele, common in East Asians, impairs aldehyde metabolism and leads to acetaldehyde accumulation during alcohol consumption. Whether this variant interacts with alcohol use to influence the age at ischemic stroke onset remains unclear. We evaluated the associations between ALDH2*2 and alcohol consumption with age at stroke onset.

Methods

We enrolled 930 patients (598 men and 332 women) with first-ever ischemic stroke. Alcohol consumption was dichotomized as heavy (>45 g/day or >300 g/week of ethanol) versus nonheavy (abstinent or ≤45 g/day and ≤300 g/week). Because heavy drinking was rare in women, primary analyses focused on men. Participants were grouped by the ALDH2 genotype (*1/*1 vs. *1/*2 or *2/*2) and drinking category. Clinical variables were compared using analysis of variance and chi-squared tests. Multivariable linear regression, adjusted for smoking, assessed associations with age at stroke onset.

Results

Among men, mean age at stroke onset differed significantly across genotype–drinking groups (p < 0.001). ALDH2*2 carriers with heavy drinking had the earliest onset (56.1 ± 9.6 years), whereas ALDH2*2 carriers with nonheavy drinking had the latest onset (63.6 ± 12.3 years). Relative to *1/*1 with nonheavy drinking, ALDH2*2 carriers with nonheavy drinking had later onset (β = 2.67 years, p = 0.023), while those with heavy drinking had earlier onset (β = −4.61 years, p = 0.048). In the overall cohort, male sex, smoking, and heavy drinking were independently associated with younger onset (β = −3.20, −2.57, and − 3.40 years; p = 0.001, 0.006, and 0.002, respectively).

Conclusions

In East Asian men, heavy alcohol consumption among ALDH2*2 carriers is associated with earlier ischemic stroke onset, suggesting a gene–environment interaction. These findings support genotype-informed lifestyle counseling for stroke prevention.

背景：ALDH2*2等位基因在东亚人中很常见，在饮酒过程中损害醛代谢并导致乙醛积累。这种变异是否与饮酒相互作用影响缺血性卒中发病年龄尚不清楚。我们评估了ALDH2*2和饮酒与中风发病年龄之间的关系。方法：我们招募了930例首次缺血性卒中患者（男性598例，女性332例）。酒精消耗量被分为重度（45克/天或300克/周）和非重度（戒酒或≤45克/天和≤300克/周）。因为酗酒在女性中很少见，所以主要的分析集中在男性身上。参与者按ALDH2基因型（*1/*1 vs. *1/*2或*2/*2）和饮酒类别分组。临床变量比较采用方差分析和卡方检验。多变量线性回归，调整吸烟因素，评估与中风发病年龄的关系。结果：在男性中，不同基因型饮酒组的平均卒中发病年龄差异显著(p)。结论：在东亚男性中，ALDH2*2携带者大量饮酒与早期缺血性卒中发病相关，提示基因-环境相互作用。这些发现支持基于基因型的生活方式咨询以预防中风。

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引用次数: 0

Impact of alcohol exposure on trauma in patients aged 60 years and older 酒精暴露对60岁及以上患者创伤的影响

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70214

İbrahim Altundağ, Batuhan Gümüşay, Burcu Genç Yavuz, Sinem Doğruyol, Kaan Yusufoğlu, Mustafa Ahmet Afacan, Şahin Çolak

Background

Trauma causes 4.4 million deaths annually, comprising 8% of global mortality. In older individuals, the risk of severe traumatic injuries increases because of reduced physical reserves and comorbidities. Alcohol use may contribute to the occurrence of trauma and worsen patient outcomes; however, its exact role remains unclear. This study aimed to evaluate the effects of alcohol exposure on trauma severity, injury patterns, and clinical outcomes in individuals aged ≥60 years.

Methods

This retrospective cross-sectional study included patients with trauma aged ≥60 years whose blood alcohol concentration (BAC) was measured in the emergency department between 2020 and 2024. Patients with BAC ≥10 mg/dL and <10 mg/dL were considered alcohol-positive (AP) and alcohol-negative (AN), respectively. The groups were compared for the cause of injury, Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), New Injury Severity Score (NISS), hospitalization, surgical intervention, and mortality.

Results

In total, 267 patients (mean age 71.7 ± 7.8 years; 57.3% men) were included. Most injuries were caused by falls (75.7%). Head–neck injuries were more frequent in AP patients (p < 0.001), whereas AN patients had more injuries in the upper (p = 0.028) and lower (p = 0.007) extremities. The average AIS score, ISS, and NISS were similar between the groups. The frequencies of GCS scores ≤8 (p = 0.020) and severe head trauma (AIS ≥ 3) (p = 0.007) were significantly higher in the AP group. Alcohol positivity was associated with higher ICU admission rates (p = 0.034) and increased in-hospital mortality rates (p = 0.017).

Conclusions

Alcohol exposure did not affect the average ISS and NISS in patients aged ≥60 years, and alcohol positivity was not associated with a significant difference in the severe injury group (ISS ≥ 16 and NISS ≥ 16). However, severe head injury and GCS scores ≤8 were observed more frequently in the AP group. Alcohol exposure is associated with increased ICU admission and higher mortality rates.

背景：创伤每年造成440万人死亡，占全球死亡率的8%。在老年人中，由于身体储备减少和合并症，严重创伤性损伤的风险增加。酒精使用可能导致创伤的发生并使患者预后恶化；然而，它的确切作用仍不清楚。本研究旨在评估酒精暴露对≥60岁个体创伤严重程度、损伤模式和临床结果的影响。方法：本回顾性横断面研究纳入了2020年至2024年间在急诊科测量血液酒精浓度（BAC）的年龄≥60岁的创伤患者。BAC≥10 mg/dL患者及结果：共纳入267例患者（平均年龄71.7±7.8岁，男性57.3%）。摔伤最多（75.7%）。结论：酒精暴露不影响年龄≥60岁患者的平均ISS和NISS，酒精阳性与严重损伤组（ISS≥16和NISS≥16）的显著差异无关。而AP组出现严重颅脑损伤及GCS评分≤8分的发生率较高。酒精暴露与ICU入院人数增加和死亡率升高有关。

{"title":"Impact of alcohol exposure on trauma in patients aged 60 years and older","authors":"İbrahim Altundağ, Batuhan Gümüşay, Burcu Genç Yavuz, Sinem Doğruyol, Kaan Yusufoğlu, Mustafa Ahmet Afacan, Şahin Çolak","doi":"10.1111/acer.70214","DOIUrl":"10.1111/acer.70214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trauma causes 4.4 million deaths annually, comprising 8% of global mortality. In older individuals, the risk of severe traumatic injuries increases because of reduced physical reserves and comorbidities. Alcohol use may contribute to the occurrence of trauma and worsen patient outcomes; however, its exact role remains unclear. This study aimed to evaluate the effects of alcohol exposure on trauma severity, injury patterns, and clinical outcomes in individuals aged ≥60 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included patients with trauma aged ≥60 years whose blood alcohol concentration (BAC) was measured in the emergency department between 2020 and 2024. Patients with BAC ≥10 mg/dL and <10 mg/dL were considered alcohol-positive (AP) and alcohol-negative (AN), respectively. The groups were compared for the cause of injury, Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), New Injury Severity Score (NISS), hospitalization, surgical intervention, and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 267 patients (mean age 71.7 ± 7.8 years; 57.3% men) were included. Most injuries were caused by falls (75.7%). Head–neck injuries were more frequent in AP patients (<i>p</i> < 0.001), whereas AN patients had more injuries in the upper (<i>p</i> = 0.028) and lower (<i>p</i> = 0.007) extremities. The average AIS score, ISS, and NISS were similar between the groups. The frequencies of GCS scores ≤8 (<i>p</i> = 0.020) and severe head trauma (AIS ≥ 3) (<i>p</i> = 0.007) were significantly higher in the AP group. Alcohol positivity was associated with higher ICU admission rates (<i>p</i> = 0.034) and increased in-hospital mortality rates (<i>p</i> = 0.017).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Alcohol exposure did not affect the average ISS and NISS in patients aged ≥60 years, and alcohol positivity was not associated with a significant difference in the severe injury group (ISS ≥ 16 and NISS ≥ 16). However, severe head injury and GCS scores ≤8 were observed more frequently in the AP group. Alcohol exposure is associated with increased ICU admission and higher mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"50 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Educational disparities in alcohol-related liver disease mortality in the 21st century: Beyond deaths of despair? 21世纪酒精相关肝病死亡率的教育差异：超越绝望死亡？

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70194

Richard A. Grucza, Joel Jihwan Hwang, Jeffrey F. Scherrer, Jennifer K. Bello, Sarah C. Gebauer, Ruizhi Huang, Joanne Salas, Kevin Young Xu

Background

Deaths from alcohol-related liver disease and associated conditions (ALD+), a major driver of alcohol-attributable mortality in the United States, are rising more rapidly than per capita alcohol consumption. These trends may stem from a broader “deaths of despair” epidemic disproportionately affecting those without a college degree. However, how ALD+ mortality trends vary by educational attainment remains underexplored. To address this, we analyzed ALD+ mortality from 2001 to 2020, focusing on disparities across educational and demographic subgroups.

Methods

We analyzed US mortality trends for adults 25 and older using a repeated cross-sectional dataset combining death records for ALD+ with population data from the American Community Survey. We examined differences in mortality trends by age, sex, race/ethnicity, and educational attainment (college degree or not). Trends were modeled using logistic regression with age as a covariate and quadratic time terms. Outcomes included proportional change in mortality (odds ratios for 2020 vs. 2001), modeled age-adjusted death rates for 2001 and 2020, and absolute change in death rate (Δ).

Results

Between 2001 and 2020, the ALD+ death rate increased by 63% (OR = 1.63; 95% CI: 1.55, 1.72), from 8.8 to 16.6 deaths per 100,000. Increases were greater among individuals without a college degree compared to those with a college degree (Δ = 12.7 vs. 2.4 per 100,000). Disparities by education widened across nearly all demographic groups.

Conclusion

Disparities in ALD+ mortality by educational attainment widened substantially between 2001 and 2020. Findings are partially consistent with the “deaths of despair” framework that initially focused on mortality among middle-aged non-Hispanic Whites but also reveal widening disparities in other demographic groups. Increased alcohol consumption alone is unlikely to fully explain these trends. Identification of social, behavioral, and medical factors contributing to increasing ALD+ deaths will shed light on opportunities for intervention focused on factors beyond alcohol consumption.

背景：酒精相关肝脏疾病及相关疾病（ALD+）的死亡是美国酒精导致死亡的主要原因，其增长速度超过了人均酒精消费量。这些趋势可能源于更广泛的“绝望死亡”流行病，对没有大学学位的人影响尤为严重。然而，ALD+死亡率趋势如何随受教育程度而变化仍未得到充分探讨。为了解决这个问题，我们分析了2001年至2020年ALD+死亡率，重点关注教育和人口亚组之间的差异。方法：我们使用一个重复的横断面数据集，结合ALD+的死亡记录和美国社区调查的人口数据，分析了美国25岁及以上成年人的死亡率趋势。我们根据年龄、性别、种族/民族和教育程度（大学学历与否）检查了死亡率趋势的差异。趋势建模使用逻辑回归与年龄作为协变量和二次时间项。结果包括死亡率的比例变化（2020年与2001年的比值比）、2001年和2020年模型年龄调整死亡率以及死亡率的绝对变化（Δ）。结果：2001年至2020年间，ALD+死亡率增加了63% (OR = 1.63; 95% CI: 1.55, 1.72)，从每10万人8.8例死亡增加到16.6例死亡。与拥有大学学位的人相比，没有大学学位的人的增幅更大（Δ = 12.7 vs.每10万人2.4）。几乎所有人口群体的教育差异都扩大了。结论：2001年至2020年间，受教育程度对ALD+死亡率的影响显著扩大。研究结果部分符合“绝望死亡”框架，该框架最初关注的是中年非西班牙裔白人的死亡率，但也揭示了其他人口群体的差距正在扩大。单凭酒精消费的增加不太可能完全解释这些趋势。确定导致ALD+死亡增加的社会、行为和医学因素，将为关注酒精消费以外因素的干预提供机会。

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引用次数: 0

Breaking the cycle: Consequences from simultaneous alcohol and cannabis use predict subsequent simultaneous use and drinks consumed at the next simultaneous use event 打破循环：同时使用酒精和大麻的后果可以预测随后的同时使用和下一次同时使用事件中所消耗的饮料。

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70183

Riley C. Tolbert, Jack T. Waddell

Background

Research suggests that simultaneous alcohol and cannabis use (vs. alcohol-only) days are associated with increased alcohol-related consequences. Less is known, however, regarding whether consequences from simultaneous use events predict the subsequent patterns of simultaneous use and drinking behavior at subsequent simultaneous use events.

Methods

Young adults who reported 2+ days of simultaneous use (N = 89) completed a 60-day timeline followback (TLFB) interview, reporting on simultaneous alcohol and cannabis use and positive/negative consequences experienced on drinking days. Multilevel models tested whether positive and negative consequences from a given simultaneous use event, and their interaction, predicted the likelihood of simultaneously using cannabis at the next drinking event and the number of standard drinks consumed during the next simultaneous use event.

Results

Contrary to hypotheses, negative consequences from a given simultaneous use event predicted a higher likelihood of cannabis use at the next drinking event, whereas positive consequences and the interaction between the two did not. However, in line with hypotheses, negative consequences from a given simultaneous use event predicted lesser drinks consumed at the next simultaneous use event. Furthermore, there was an interaction between positive/negative simultaneous use consequences predicting drinking quantity during the next simultaneous use event, such that negative consequences from a given simultaneous use event predicted lesser drinks consumed at the next simultaneous use event when positive consequences from the given event were lower (but not higher) than average.

Conclusions

Findings lend valuable information that may aid substance use prevention and intervention efforts seeking to dissuade against habitual cycles of high-risk simultaneous use. Findings also provide some evidence of a “teachable moment” from simultaneous use consequences.

背景：研究表明，同时使用酒精和大麻（与只使用酒精相比）的日子与酒精相关的后果增加有关。然而，关于同时使用事件的后果是否能预测随后的同时使用模式和随后的同时使用事件中的饮酒行为，我们知之甚少。方法：报告同时使用2天以上的年轻人（N = 89）完成了为期60天的时间轴随访（TLFB）访谈，报告了同时使用酒精和大麻以及饮酒日经历的积极/消极后果。多层模型测试了给定同时使用事件的积极和消极后果及其相互作用是否预测了在下一次饮酒事件中同时使用大麻的可能性以及在下一次同时使用事件中消耗的标准饮料数量。结果：与假设相反，给定同时使用事件的负面后果预测下一次饮酒事件中使用大麻的可能性更高，而积极后果和两者之间的相互作用则没有。然而，与假设一致的是，给定的同时使用事件的负面后果预示着下一次同时使用事件的饮酒量会减少。此外，在预测下一个同时使用事件的饮酒量的积极/消极同时使用后果之间存在相互作用，例如，当给定事件的积极后果低于（但不高于）平均水平时，给定同时使用事件的消极后果预测下一个同时使用事件的饮酒量较少。结论：研究结果提供了有价值的信息，可能有助于物质使用的预防和干预努力，以劝阻高危同时使用的习惯性循环。研究结果还从同时使用的后果中提供了一些“可教时刻”的证据。

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引用次数: 0

Regional cerebellum volume anomalies and associated cognitive function in children with fetal alcohol spectrum disorders 胎儿酒精谱系障碍儿童的区域性小脑体积异常及相关认知功能

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70207

Blake A. Gimbel, Donovan J. Roediger, Kent A. Tuominen, Mary E. Anthony, Alexandra L. Doughty, Abigail M. Ernst, Bryon A. Mueller, Erik de Water, the CIFASD, Jeffrey R. Wozniak

Background

Prenatal alcohol exposure (PAE) significantly impacts cerebellar development, which may affect cognitive function in fetal alcohol spectrum disorders (FASD). We evaluated cerebellar anomalies in children with FASD and an unexposed comparison group using an advanced MRI volumetric method that characterizes cerebellar structure at the level of individual lobules. We also explored associations between the cerebellum and cognitive performance.

Methods

Forty-seven children with FASD and 46 typically developing comparisons (ages 8–17 years). Participants completed a 3T MRI scan and cognitive testing including IQ, executive function, visual memory, and visual-motor processing speed. T1-weighted anatomical data were processed with the CerebNet pipeline, which segments the cerebellum into lobules. Univariate and multivariate linear models (with intracranial volume [ICV] as a covariate) examined group volume differences for total cerebellar volumes and individual cerebellar lobules. Exploratory analyses examined associations between cognitive functioning and cerebellum volumes.

Results

Participants with FASD demonstrated lower volumes than comparison participants in total bilateral cerebellar white and cortical gray matter, and a smaller total vermis. Participants with FASD had lower regional volumes than comparisons within the bilateral lobules I–IV and V (anterior lobe) and vermis X lobule (flocculonodular lobe). Within the FASD group, a larger volume in the total cerebellar white matter was a significant predictor of better performance on measures of verbal working memory and processing speed. Within the comparison group, a larger volume of lobule V was a significant predictor of better verbal working memory, while a larger volume of lobule I–IV was a significant negative predictor of better verbal working memory.

Conclusions

A novel MRI method to evaluate cerebellum morphology in children with FASD suggests that PAE is associated with cerebellum anomalies in a regionally specific manner. The data also suggest that structural anomalies of the cerebellum may have functional consequences for important cognitive skills in children with FASD.

背景：产前酒精暴露（PAE）显著影响小脑发育，可能影响胎儿酒精谱系障碍（FASD）的认知功能。我们使用先进的MRI体积测量方法在单个小叶水平上表征小脑结构，评估了FASD儿童和未暴露对照组的小脑异常。我们还探讨了小脑和认知表现之间的联系。方法：47例FASD患儿和46例典型发展对照（8-17岁）。参与者完成了3T核磁共振扫描和认知测试，包括智商、执行功能、视觉记忆和视觉运动处理速度。t1加权解剖数据用CerebNet管道处理，该管道将小脑分割成小叶。单变量和多变量线性模型（以颅内体积[ICV]作为协变量）检查了小脑总体积和单个小脑小叶的组体积差异。探索性分析检验了认知功能和小脑体积之间的关系。结果：与对照组相比，FASD患者的双侧小脑白质和皮质灰质总量更低，蚓总体积更小。与双侧小叶I-IV和V（前叶）以及蚓部X小叶（小叶结节）相比，FASD参与者的区域体积更小。在FASD组中，小脑白质总量越大，在言语工作记忆和处理速度的测量中表现越好。在对照组中，较大体积的小叶V是较好的言语工作记忆的显著预测因子，而较大体积的小叶I-IV是较好的言语工作记忆的显著负向预测因子。结论：一种评估FASD儿童小脑形态的新MRI方法表明，PAE与小脑异常以区域特异性方式相关。这些数据还表明，小脑的结构异常可能对FASD儿童的重要认知技能产生功能上的影响。

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引用次数: 0

Investigating the bidirectional association between alcohol use and suicidal thoughts and behaviors in a population from the United States 在美国人群中调查酒精使用与自杀想法和行为之间的双向关联。

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70206

Séverine Lannoy, Mallory Stephenson, Jacyra Araujo, Luis F. S. Castro-de-Araujo, Alexis C. Edwards

Background

The association between alcohol problems and suicidal thoughts and behaviors (STB) is well documented, with recent evidence suggesting a causal effect of alcohol. Nevertheless, it is unclear if this relationship extends to less severe alcohol phenotypes. Moreover, only a few studies have explored whether STB may also increase alcohol use/problems. In this study, we combined two complementary methods to improve causal inference and investigate the bidirectional associations between alcohol use and STB.

Methods

We used the National Longitudinal Study of Adolescent to Adult Health (Add Health) with information on alcohol use and suicide ideation and attempts across five waves of data (age ranges: 10–43). First, we fit a cross-lagged panel model using data from Waves I–V to test the bidirectional associations between alcohol use and suicide ideation/attempt. This model advances causal knowledge by leveraging longitudinal data and controlling for unmeasured confounders related to both alcohol use and STB. Data from 17,908 unrelated participants were included in the model. Second, we included data from cousins, half-siblings, full siblings, and monozygotic (MZ) twin pairs to perform co-relative analyses, enhancing causal inference by controlling for unmeasured genetic and familial confounders.

Results

Cross-lagged findings showed small positive associations from suicide ideation to alcohol use (βs = 0.045–0.050) and from alcohol use to suicide ideation (β = 0.064) during adolescence/early adulthood in females. In males, results indicated one significant association between alcohol use in late adolescence and suicide attempt in adulthood (β = 0.508). Co-relative analyses revealed small but significant associations between alcohol use and STB in full siblings (OR = 1.41), but results in MZ twins were mostly inconclusive due to a lack of power.

Conclusion

Our results suggest complex and potentially bidirectional associations between alcohol and suicide phenotypes, but do not provide strong evidence for a causal pathway.

背景：酒精问题与自杀想法和行为（STB）之间的联系是有充分记录的，最近的证据表明酒精有因果关系。然而，尚不清楚这种关系是否延伸到不那么严重的酒精表型。此外，只有少数研究探讨了STB是否也可能增加酒精使用/问题。在本研究中，我们将两种互补的方法结合起来，以改进因果推理，并调查酒精使用与STB之间的双向关联。方法：我们使用了国家青少年到成人健康纵向研究（Add Health），其中包括五波数据（年龄范围：10-43岁）中关于酒精使用和自杀意念和企图的信息。首先，我们使用Waves I-V的数据拟合了一个交叉滞后面板模型，以检验酒精使用与自杀意念/企图之间的双向关联。该模型通过利用纵向数据和控制与酒精使用和STB相关的未测量混杂因素，提高了因果知识。来自17908名不相关参与者的数据被纳入模型。其次，我们纳入了表兄妹、同父异母兄弟姐妹、全兄妹和同卵双胞胎的数据来进行相关分析，通过控制未测量的遗传和家族混杂因素来增强因果推理。结果：交叉滞后的研究结果显示，在青春期/成年早期，女性自杀意念与酒精使用（βs = 0.045-0.050）和酒精使用与自杀意念（β = 0.064）之间存在微小的正相关。在男性中，结果表明青春期晚期饮酒与成年后自杀企图之间存在显著关联（β = 0.508）。相关分析显示，在全兄妹中，酒精使用与STB之间存在微小但显著的关联（OR = 1.41），但在MZ双胞胎中，由于缺乏权力，结果大多不确定。结论：我们的研究结果表明，酒精和自杀表型之间存在复杂且潜在的双向关联，但没有提供强有力的因果关系证据。

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引用次数: 0

Latent motivational profiles of behavioral regulations for drinking distinguish groups by alcohol consumption and consequences 饮酒行为规则的潜在动机特征通过饮酒和后果区分各组。

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70185

Jimikaye B. Courtney, Michael A. Russell, David E. Conroy

<div> <section> <h3> Background</h3> <p>Self-determination theory characterizes drinking motives according to level of autonomy and locus of control and aligns with harm reduction approaches to alcohol use. This study used latent profile analysis (LPA) to identify motivational profiles of self-determined behavioral regulations for drinking and to test their associations with sociodemographic variables and alcohol consumption and outcomes.</p> </section> <section> <h3> Methods</h3> <p>Adults aged 18–57 (<i>N</i> = 630, <i>M</i><sub>age</sub> = 21.5, 55% female, 88% undergraduates) reported typical alcohol consumption (Daily Drinking Questionnaire), consequences (Brief Young Adult Alcohol Consequences Questionnaire, Importance of Consequences of Drinking), and five behavioral regulations for drinking including amotivation, external regulation, positive introjected regulation, identified regulation, and intrinsic regulation (Comprehensive Relative Autonomy Index for Drinking). Three-step LPA tested models with one to five profiles and associations between the final model with sociodemographic variables and drinking behaviors and consequences.</p> </section> <section> <h3> Results</h3> <p>A four-profile model fit best. The “Aimless Drinkers” profile (<i>n</i> = 75, 11.9%) had low intrinsic regulation (e.g., enjoyment of drinking) and was disproportionately male (ORs = 2.35–2.65). The “Pleasure Drinker” profile (<i>n</i> = 114, 18.1%) had average intrinsic and low other regulations and was significantly older (OR = 1.07) than the “Externally Controlled Drinker” profile (<i>n</i> = 177, 28.1%), which had high external regulation (e.g., drinking due to social pressure). Externally controlled drinkers reported greater drinking intensity (<i>M</i><sub>drinks/day</sub> = 5.4) and more negative (<i>M</i><sub>neg</sub> = 10.6) and positive (<i>M</i><sub>pos</sub> = 7.2) consequences than all other profiles, including the “Flexible Drinker” profile (<i>n</i> = 264, 41.9%), which was average across all regulations. Pleasure drinkers experienced more positive consequences (<i>M</i><sub>pos</sub> = 3.3 vs. 1.5) than aimless drinkers, despite similar alcohol consumption.</p> </section> <section> <h3> Conclusions</h3> <p>Older individuals were more likely to drink due to intrinsic enjoyment, which may reflect a shift toward greater autonomy over alcohol consumption with increasing age. Drinking primarily for enjoyment also facilitated more positive drinking outcomes. Future research should investigate whether motivational profiles of behavioral regulations for drinking predict long-term trajectories of alcohol consumption and alcohol-related risks.

背景：自我决定理论根据自主性和控制点的水平来描述饮酒动机，并与减少酒精使用的危害方法相一致。本研究使用潜在特征分析（LPA）来确定饮酒自我决定行为规范的动机特征，并测试其与社会人口学变量、酒精消费和结果的关联。方法：18-57岁成人（N = 630，年龄为21.5，女性55%，大学生88%）报告典型饮酒量（每日饮酒问卷）、饮酒后果（青年成人饮酒后果简要问卷、饮酒后果重要性）以及饮酒行为的五种行为调节，包括动机调节、外部调节、积极内向调节、识别调节和内在调节（饮酒综合相对自主性指数）。三步LPA测试了具有一到五个概况的模型，以及最终模型与社会人口变量和饮酒行为及其后果之间的关联。结果：四剖面模型最适合。“无目的饮酒者”（n = 75, 11.9%）的内在调节能力较低（例如，享受饮酒），而且男性比例不成比例（or = 2.35-2.65）。“享乐饮酒者”（n = 114, 18.1%）具有平均的内在调节和较低的其他调节，并且明显比“外部控制饮酒者”（n = 177, 28.1%）更老（OR = 1.07），后者具有较高的外部调节（例如，由于社会压力而饮酒）。外部控制饮酒者报告的饮酒强度更高（Mdrinks/day = 5.4），负面（Mneg = 10.6）和正面（Mpos = 7.2）的后果比所有其他情况都要多，包括“灵活饮酒者”情况（n = 264, 41.9%），这是所有规定的平均值。尽管饮酒量相似，但快乐饮酒者比无目的饮酒者体验到更多的积极结果（Mpos = 3.3 vs. 1.5）。结论：老年人更有可能因为内在的享受而喝酒，这可能反映了随着年龄的增长，人们对饮酒的自主性越来越强。以享受为主的饮酒也促进了更积极的饮酒结果。未来的研究应该调查饮酒行为调节的动机特征是否能预测酒精消费和酒精相关风险的长期轨迹。

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引用次数: 0

Effects of cannabidiol in alcohol use disorder patients with and without co-occurring post-traumatic stress disorder: Tolerability but no evidence for efficacy in two randomized proof-of-concept trials 大麻二酚对伴有或不伴有创伤后应激障碍的酒精使用障碍患者的影响：两项随机概念验证试验的耐受性，但没有疗效证据

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2025-11-28 DOI: 10.1111/acer.70212

Michael P. Bogenschutz, Esther Blessing, Danielle Dgheim, Dayeon Cho, Jun Zhang, Eugene M. Laska, Charles R. Marmar

Background

Comorbidity between alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) exacerbates symptom severity and worsens treatment outcomes. Limited clinical research suggests that cannabidiol (CBD) may have therapeutic effects on anxiety disorders and addictive behavior, but efficacy has not been established.

Methods

Two proof-of-concept trials of CBD were conducted simultaneously. In Study 1, 27 adults with moderate to severe AUD were randomized to CBD [600 mg/day for 4 weeks, then 1200 mg/day for 4 weeks] versus placebo. In Study 2, 30 adults with AUD plus DSM-5 PTSD or subthreshold post-traumatic stress disorder (PTSD) were randomized to CBD 600 mg/day vs. placebo for 6 weeks. The trials assessed CBD pharmacokinetics, safety and tolerability, alcohol consumption, craving, mood and anxiety symptoms, and, in Study 2, PTSD symptom severity. Efficacy analyses used mixed-effects models, and the primary drinking outcome was the average number of drinks per day during treatment.

Results

CBD was rapidly absorbed, achieving near-steady-state trough levels by week 1, with dose-dependent increases during weeks 5–8 in Study 1. Mean trough and estimated peak CBD levels at week 4 (n = 20) were 31.15 (SD: 21.22) ng/mL and 130.75 (SD: 152.57) ng/mL, respectively. Few safety concerns emerged, but 7/31 (22.6%) of participants assigned to CBD experienced dose-limiting side effects. In both studies, participants in both treatment groups showed large reductions in drinks per day and percentage heavy drinking days during treatment (Cohen's dz. > 0.9). Neither trial demonstrated superiority of CBD over placebo for drinking outcomes, craving, mood, anxiety, or PTSD symptoms.

Conclusions

These findings support the feasibility and tolerability of twice-daily oral CBD up to 1200 mg/day in actively drinking individuals but do not demonstrate efficacy at the CBD levels that were achieved in this study. Further dose finding and larger, well-powered trials are needed to clarify CBD's therapeutic potential in AUD and comorbid PTSD.

背景：酒精使用障碍（AUD）和创伤后应激障碍（PTSD）之间的共病加重了症状的严重程度并恶化了治疗结果。有限的临床研究表明，大麻二酚（CBD）可能对焦虑症和成瘾行为有治疗作用，但疗效尚未确定。方法：同时进行两项CBD的概念验证试验。在研究1中，27名患有中度至重度AUD的成年人被随机分配到CBD组[600 mg/天，持续4周，然后1200 mg/天，持续4周]和安慰剂组。在研究2中，30名AUD合并DSM-5 PTSD或阈下创伤后应激障碍（PTSD）的成年人被随机分为CBD 600 mg/天组和安慰剂组，持续6周。试验评估了CBD的药代动力学、安全性和耐受性、酒精消耗、渴望、情绪和焦虑症状，在研究2中，评估了PTSD症状的严重程度。疗效分析使用混合效应模型，主要的饮酒结果是治疗期间每天的平均饮酒量。结果：CBD被迅速吸收，在第1周达到接近稳定的低谷水平，在研究1的5-8周期间剂量依赖性增加。第4周（n = 20） CBD平均波谷和估计峰值水平分别为31.15 (SD: 21.22) ng/mL和130.75 (SD: 152.57) ng/mL。很少出现安全问题，但分配给CBD的参与者中有7/31（22.6%）经历了剂量限制的副作用。在这两项研究中，两个治疗组的参与者在治疗期间每天的饮酒量和重度饮酒天数的百分比都大幅减少（Cohen's dz. > . 0.9）。两项试验均未证明CBD在饮酒结果、渴望、情绪、焦虑或PTSD症状方面优于安慰剂。结论：这些研究结果支持积极饮酒个体每日两次口服CBD高达1200毫克/天的可行性和耐受性，但并未证明本研究中达到的CBD水平的有效性。需要进一步的剂量发现和更大规模、更有力的试验来阐明CBD在AUD和共病PTSD中的治疗潜力。

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引用次数: 0