Specific diagnostic criteria identify those at high risk for progression from ‘preaddiction’ to severe alcohol use disorder

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: June 20, 2023

Abstract Importance Both current DSM-5 diagnoses of substance use disorders (SUDs) and the recent “preaddiction” conceptual proposal (i.e., mild-to-moderate SUD) rely on criterion count-based approaches, without consideration evidence regarding varying severity grading indexed by individual criteria. Objective To examine correlates alcohol disorder (AUD) across groups mild, moderate, mild-to-moderate, severe), identify specific diagnostic criteria indicative greater severity, evaluate whether presence within AUD differentiates relevant manifests in hazards severe development. Design Cross-sectional longitudinal cohort study. Setting Family-based study individuals from seven sites United States. Participants ( N =13,110; mean [SD] age, 37.8 [14.2] years) cohorts =2,818; baseline 16.1 [3.2] Collaborative Study Genetics Alcoholism (COGA). Exposure N/A Main Outcomes Measures Sociodemographic, alcohol-related, psychiatric comorbidity (major depressive disorder, antisocial personality other SUDs), brain electroencephalography (EEG), polygenic score measures as levels severe) severity-defined low-risk vs. high-risk mild-to-moderate) groups. Results Associations with psychiatric, EEG, reinforced role increasing counts indexing severity. Yet even those meeting for (2-5 criteria), “high-risk” (e.g., withdrawal) identified a group reporting heavier drinking after accounting count differences. In analyses, prior characterized endorsement at least one outperformed adolescent young adult progression comorbid diagnoses, involvement milestones) was associated more accelerated to (adjusted hazard ratio [aHR], 11.62; 95% CI, 7.54-17.92) compared (aHR, 5.64; 3.28-9.70), independent count. Conclusions Relevance Current approaches concept both ignore heterogeneity among Estimating addiction vulnerability emphasizing may improve our understanding its development focus attention greatest risk. Key Points Question Does emphasis identification risk developing AUD? Findings Individuals are two-fold likely progress if they endorse despite physical/psychological problems, giving up important activities, spending great deal time drinking, failure fulfill major obligations, withdrawal, craving, total Meaning Emphasis especially indicators increase detection likelihood progression.

Language: Английский

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Predictors of symptom course in alcohol use disorder

Alcohol Clinical and Experimental Research, Journal Year: 2023, Volume and Issue: 47(12), P. 2288 - 2300

Published: Sept. 30, 2023

Symptoms often play an important role in the scientific inquiry of psychological disorders and have been theorized to a functional themselves. However, little is known about course specific symptoms individual differences course. Understanding factors influencing symptom can inform theory future research on treatment.

Language: Английский

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Culture and ICD-11 personality disorder: Implications for clinical practice across diverse ethnic groups

International Journal of Social Psychiatry, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 18, 2024

Personality disorder (PD) in ICD-11 is defined primarily by self and interpersonal dysfunction optionally other qualifiers. This definition inseparable from relativism of cultural determinants.

Language: Английский

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Association between adverse childhood experiences and gastro-esophageal diseases later in life: A large-population cohort and Mendelian randomization study

Journal of Affective Disorders, Journal Year: 2024, Volume and Issue: 372, P. 66 - 74

Published: Nov. 28, 2024

Language: Английский

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Transdiagnostic Impulsivity-Relevant Phenotypes and the Comorbidity of Personality Disorders with Substance and Alcohol Use Disorders

Current Addiction Reports, Journal Year: 2023, Volume and Issue: 10(2), P. 122 - 130

Published: May 8, 2023

Language: Английский

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Commentary on Watts et al.: What can comorbidity teach us about the nature of alcohol problems?

Addiction, Journal Year: 2023, Volume and Issue: 118(8), P. 1469 - 1470

Published: June 12, 2023

Studying comorbidity helps to identify mechanisms that underly alcohol problems. Watts et al. examine the influence of internalizing and externalizing on use disorder (AUD) criteria link potential phenotypes. New methods evaluate how we classify understand problems are revealing promising The dependence syndrome [1] [currently (AUD)] captures key features from many ways in which humans get into trouble with alcohol: young professional arrested a night out friends for antisocial behaviour while intoxicated, full remorse fearful reputational damage; middle-aged executive estranged her family, depressed drinking herself sleep alone each night; older male 30-year history heavy liver disease, perplexed because he drinks less than his ‘healthy’ friends. From heterogeneous such as these, distil remarkably coherent unidimensional [2] (rather categorical [3]) set diagnostic AUD. This conceptualization has clear value, but if it captured little more variability between people, could be useful? AUD is rarely diagnosed alone. In addition comorbid physical conditions, other mental disorders often present. Is this an artefact poorly specified criteria, or can teach us something about nature problems? may reveal deeper structure disorders. hierarchical taxonomy psychopathology (HiTOP) leading contender dimensional reconceptualization [4]. Interestingly, do not appear overlap DSM [5], suggesting result criteria. [6] look ‘under hood’ at relationships conditions. They summarize two well-known HiTOP super-spectra—internalizing externalizing. one advantage HiTOP—to move up down choose best level ‘resolution’ their question. multiple indicators causes (MIMIC) models relationship There number conditions (Neale & Kendler describe six [7]). Do they add together functional impairment, disability complexity treatment, interact greater impact? Can MIMIC test whether so pattern symptoms different when present? found tolerance no likely presence (holding equal). Withdrawal related internalizing, simply effect distress. Recurrent hazardous situations was higher lower internalizing. When split fear distress, there were significant impacts any These findings suggest specific phenotypes discuss results broadly consistent Koob Le Moal allostatic theory addiction [8]. However, predictions regarding role negative affect supported Watt al.’s results. Results also Dawe 2-CARS reward drive rash impulsivity model [9] behavioural approach inhibition systems Gray’s reinforcement sensitivity [10]. exciting opportunities advance empirical classification problems! Andrew J Baillie: Conceptualization (equal); writing—original draft writing—review editing (equal). Open access publishing facilitated by University Sydney, part Wiley - Sydney agreement via Council Australian Librarians. None. No data available.

Language: Английский

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Association Patterns of Antisocial Personality Disorder across Substance Use Disorders

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Sept. 15, 2023

There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there limited information on the specific patterns association ASPD with SUD severity and diagnostic criteria. We investigated alcohol, cannabis, cocaine, opioid, tobacco (AUD, CanUD, CocUD, OUD, TUD, respectively) 1,660 6,640 controls matched sex (24% female), age, racial/ethnic background sample ascertained for addiction-related traits. Generalized linear regressions were used to test five DSM-5 diagnoses, their (i.e., mild, moderate, severe), individual found that associated diagnosis AUD (Odds Ratio, ORs=1.89 1.25), CanUD (ORs=2.13 1.32), TUD (ORs=1.50 1.21) (

Language: Английский

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