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The article presents the discussion on correction notice "Gender Differences in Alcohol Treatment" including threat to health worldwide and leads to substantial expenses for society.

Community reinforcement and family training (CRAFT) was developed to help and support concerned significant others (CSO) of people with, for example, alcohol use disorder. The aim of this study was to investigate therapists' experiences of working with CRAFT and their experiences of the CSOs receiving CRAFT. The study has a qualitative design and is based on three focus group interviews with 17 therapists. Interviews were analysed using thematic analysis. The analysis revealed six themes and four subthemes: Concerned significant others—A special group; Help prior to CRAFT—Offering information and a shoulder; CRAFT as a new and specific method (The toolbox of CRAFT, Formats for delivering CRAFT, Introducing a diary as homework and Implementing self‐help material—Alone or in combination with sessions); Moving from a lack of structure to structure; Change in CSOs from the therapists' point of view; and Change in the therapist's role (Dilemmas—Personalising the intervention). The therapists were generally satisfied with the method and found it easy to adapt to. Moreover, working using a manual was more structured than they were used to and increased feelings of working professionally with the CSOs. Specifically, most therapists found the self‐help book useful and indispensable in their work with CRAFT, but also agreed that it could not be used as a stand‐alone intervention for most CSOs. The therapists' experiences are relevant for implementation of manualised, structured approaches and group‐based interventions more broadly. [ABSTRACT FROM AUTHOR]

Introduction: In the last 20 years, there has been growing evidence that heavy drinking causes serious harm not only to the person who drinks but also to the person's relations and concerned significant others (CSOs). A relationship with a heavy drinker is often full of conflicts, and CSOs are frequently exposed to aggression, psychological, and sometimes physical violence from the heavy drinker. Despite their struggles, CSOs often feel it is difficult to seek professional help for these problems. The aim of this study was to investigate what problems CSOs of people with alcohol problems experience prior to seeking professional help to handle these issues. Moreover, to investigate what led to seeking professional help at all. Methods: This is a qualitative study with 12 female help-seeking CSOs of persons with alcohol problems. The participants were recruited from a randomised controlled trial (RCT) on Community Reinforcement and Family Training (CRAFT). Semi-structured interviews were conducted, audio-recorded, and transcribed. The analysis was based on interpretative phenomenological analysis. Results: Three overall themes and one sub-theme emerged from the analysis: (1) The CSO's feelings and experiences of the situation prior to help-seeking, (2) The relationship with the drinker, (3) Reasons for help-seeking and its trajectory; and the sub-theme, What the CSOs hoped to gain from help-seeking. Conclusion: The present study showed that female CSOs of people with alcohol problems had suffered for a long time before seeking professional help. They felt their daily lives were unpredictable and stressful. They were often exposed to verbal and mental abuse and their relationships with the drinking relative were often characterised by frequent rowing. The CSOs had tried to cope for a long time using a number of different strategies; seeking help seemed to be the last option considered. Despite all the struggles and pain, the CSOs also felt a lot of love for their drinking relative and hoped for the return of their once sober relative. Our findings can be viewed as a support to the stress-strain-coping-support (SSCS) model proposed by Orford and colleagues. [ABSTRACT FROM AUTHOR]

Background: Alcohol Use Disorder (AUD) is a destructive and serious problem among indigenous populations around the world. The drinking pattern differs from the non-indigenous populations by being short-term risky drinking such as binge drinking. In general, the treatment offered is based on conventional western strategies, though, in many regions' treatment facilities are poor. The present review summarizes the researched possibilities for alcohol treatment specific to indigenous populations. Method: A systematic search in four databases, Pubmed, Psyinfo, Cochcrane and Cinahl within the past ten years identified 19 articles that investigate the effect of different approaches to treat indigenous people with AUD. Result: Several studies suggest implementing native and traditional ways of healing in the treatment. Community-driven approaches have shown effect in the reduction of AUD among indigenous youth, as well as a web based brief intervention, motivational interviewing, and alcohol restrictions. Also, naltrexone as firstline medical treatment is suggested. Discussion and conclusion: In general, the studies included have a moderate to low quality and are difficult to compare but can provide an overview of elements that seem important in the treatment of indigenous people. There is a lack of research of both conventional treatment and treatment specific tailored to indigenous populations. The latter specifically minded to community prevention, the involvement of local people and implementing cultural traditions and healing methods and rebuilding native identity, seems as important elements in future treatment and prevention strategies. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies have shown that patients’ anxiety and dissatisfaction are predictors for increased postoperative pain and reduced efficacy of pain treatment. However, it remains to be shown whether patient anxiety and concern are predictors for the perceived quality of treatment and patient reported outcome (PRO). The aim of this study is to investigate whether there is a correlation between preoperative anxiety and concern, and the perceived quality of postoperative treatment and outcome. The hypothesis is that anxious and concerned patients are less satisfied with treatment and have a poorer outcome. Methods/design This study is designed as a prospective follow-up study and has the aim of investigating the correlation between patient anxiety and concern, patients´ perceived quality of treatment and outcome. This correlation will be detected using five questionnaires: CMD-SQ (Common Mental Disorders Screening Questionnaire), EuroQol 5 Dimensions (EQ-5D), Short form 12 (SF-12), “What is your evaluation of the patient progress in the Department of Orthopaedic Surgery?” (HVOK), Questionnaire for patients who have had hip surgery (RCS) and Oxford Hip Score (OHS) or Oxford Shoulder Score (OSS). The patients will complete the above mentioned questionnaires preoperatively in the outpatient department, and postoperatively just before discharge from the inpatient department, and 12 and 52 weeks after the operation. The study includes a reliability test of CMD-SQ regarding this specific population and tested by means of a Kappa. A total of 500 hip- and shoulder-patients will be included from October 2010 till October 2011. Discussion If a correlation between patient anxiety and concern, patients´ perceived quality of treatment and patient reported outcome is found, it will be recommended to screen all hip- and shoulder-patients for anxiety and concern preoperatively. Besides, it would be relevant to carry out investigations of possible interventions towards anxious and concerned patients. Trial registration Current Controlled Trials: NCT01205295

The article presents the discussion on correction notice "Gender Differences in Alcohol Treatment."

Objectives: To investigate the psychometric properties of the frequently used Alcohol Dependence Scale (ADS) in older adults and the associations between ADS scores and alcohol use and DSM‐5 AUD symptom counts. Methods: Using baseline data from an international multicenter RCT on outpatient AUD treatment for adults aged 60+ with DSM‐5 alcohol use disorder (AUD; n = 529), we computed Cronbach's alpha (α) and applied confirmatory (CFA) and exploratory factor analysis (EFA) to determine the underlying factor structure. A structural equation model (SEM) explored the interrelationship of latent ADS factors with alcohol use and number of DSM‐5 criteria endorsed. Results: Internal consistency of the ADS (α = 0.81) was good. EFA revealed a three‐factor structure. Factor 1 ("Severe withdrawal symptoms") consisted of severe psychoperceptual and psychophysical consequences of excessive drinking, Factor 2 ("Loss of control") consisted of acute physical reactions of intoxication, and Factor 3 ("Obsessive–compulsive drinking") described habitual drinking. The SEM suggested that only Factor 3 had large effects on DSM‐5 symptom score and drinking behavior. Conclusion: Lowering the ADS threshold or focusing on ADS items from Factor 3 may be more suitable measures of severity of alcohol dependence in treatment‐seeking older adults as ADS scores are low and not closely related to DSM‐5 AUD. [ABSTRACT FROM AUTHOR]

Aim: To examine whether adding the Community Reinforcement Approach for Seniors (CRA‐S) to Motivational Enhancement Therapy (MET) increases the probability of treatment success in people aged ≥ 60 years with alcohol use disorder (AUD). Design A single blind multi‐centre multi‐national randomized (1 : 1) controlled trial. Setting: Out‐patient settings (municipal alcohol treatment clinics in Denmark, specialized addiction care facilities in Germany and a primary care clinic in the United States). Participants: Between January 2014 and May 2016, 693 patients aged 60+ years and fulfilling DSM‐5 criteria for AUD participated in comparing MET (n = 351) and MET + CRA‐S (n = 342). Intervention and comparator: MET (comparator) included four manualized sessions aimed at increasing motivation to change and establishing a change plan. CRA‐S (intervention) consisted of up to eight further optional, manualized sessions aimed at helping patients to implement their change plan. CRA‐S included a specially designed module on coping with age and age‐related problems. Measurements The primary outcome was either total alcohol abstinence or an expected blood alcohol concentration of ≤ 0.05% during the 30 days preceding the 26 weeks follow‐up (defined as success) or blood alcohol concentration of > 0.05% during the follow‐up period (defined as failure). This was assessed by self‐report using the Form 90 instrument. The main analysis involved complete cases. Findings The follow‐up rate at 26 weeks was 76.2% (76.9% in the MET group and 76.0% in the MET + CRA‐S group). The success rate in the MET group was 48.9% [95% confidence interval (CI) = 42.9–54.9%] versus 52.3% (95% CI = 46.2–58.3%) in the MET + CRA‐S group. The odds of success in the two conditions did not differ (odds ratio = 1.22. 95% CI = 0.86–1.75, P = 0.26, Bayes factor = 0.10). Sensitivity analyses involving alternative approaches to missing values did not change the results. Conclusions: In older adults with an alcohol use disorder diagnosis, adding the 'community reinforcement approach for seniors' intervention to brief out‐patient motivational enhancement therapy treatment did not improve drinking outcome. [ABSTRACT FROM AUTHOR]