Search

Copyright of Clinica y Salud is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Substance Use & Misuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Current research suggests that Diagnostic and Statistical Manual of Mental Disorder (DSM)-IV alcohol abuse and dependence form a unidimensional continuum in emergency department (ED) patients in 4 countries: Argentina, Mexico, Poland, and the United States. In this continuum of alcohol use disorder (AUD), there are no clear-cut distinctions between the criteria for dependence and abuse in the severity dimension based on prior results from item response theory (IRT) analysis. Nevertheless, it is desirable to find a threshold for identifying cases for clinical practice and cut-points of clinical utility in this continuum to distinguish between patients more or less affected by an AUD, using a scale of symptoms count. Data from 5,193 patients in 7 ED sites in the same 4 countries (3,191 current drinkers) were used to study the structure, threshold, and possible cut-points for the diagnoses of AUD. The proposed changes in the DSM-V, dropping the abuse item 'legal problems' and adding an item on 'craving,' did not impact the IRT performance and unidimensionality of AUD in this sample. With a total set of 11 items (deleting 'legal problems' and adding 'craving' to the current set of DSM criteria), an endorsement of 2 or more criteria can be used as the threshold to define those with an AUD in clinical practice. Furthermore, we can distinguish at least 2 levels of clinical severity, 2 to 3 criteria (moderate), and 4 or more criteria (severe). A dimensional approach to AUD using the proposed new set of criteria for the DSM-V can be used to propose a threshold and levels of severity. More research in different populations and countries is needed to further substantiate a threshold and cut-points that could be used in new formulations of substance use disorders. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims To determine the relative risk (RR) of non-fatal injury associated with alcohol consumption in a series of emergency departments (EDs), possible effect modifiers and the impact of contextual variables on differences across sites. Design The case–crossover method was used to obtain RR estimates of the effect of alcohol on non-fatal injuries. Meta-analysis was used to evaluate the consistency and magnitude of RR across sites, and the extent to which contextual variables explain differences in effect sizes. Participants Probability samples of 11 536 injured patients attending 28 EDs studies in 16 countries (1984–2002). The majority of the sample was male (65%) and > 30 years old (53%). Measurements Exposed cases where those that consumed alcohol 6 hours prior to the injury. Usual alcohol consumption served as the control period. Findings Drinking within 6 hours prior to the injury was reported by 21% of the sample. The estimated (random) pooled relative risk for patients who reported alcohol use within 6 hours prior to injury was 5.69 (95% confidence interval = 4.04–8.00), ranging from 1.05 in Canada to 35.00 in South Africa. Effect size was not homogeneous across studies, as societies with riskier consumption patterns had a higher relative risk for injury. Heavier drinkers also showed lower RR. Conclusions Acute alcohol was a risk factor for non-fatal injuries in most sites. Policy measures addressed to the general population are recommended, especially in societies with riskier consumption patterns. [ABSTRACT FROM AUTHOR]