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Siljeholm O, Ekström V. A shift in focus: Mothers' descriptions of sharing a child with a co-parent with unhealthy alcohol use after participating in a support program. Addict Sci Clin Pract 2023; 18:12. [PMID: 36793090 PMCID: PMC9930315 DOI: 10.1186/s13722-023-00369-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Unhealthy alcohol use (UAU) affects not only the drinking individual, but also significant others (SOs), such as partners and children. Most of the harm to others caused by alcohol can be attributed to common, moderate drinking patterns, but existing studies have mainly included SOs of individuals with severe UAU. There is a need for increased knowledge regarding SOs of individuals in an earlier stage of UAU and efficacious support programs for this group. The aims of this study were to investigate reasons for seeking support as described by SOs sharing a child with a co-parent with UAU and to investigate how SOs perceived effects of a web-based self-delivered support program. METHODS A qualitative design conducting semi-structured interviews with 13 female SOs sharing a child with a co-parent with UAU. The SOs were recruited from a randomized controlled trial of the web-based program and had completed at least two of four modules in the program. Transcribed interviews were analyzed using conventional qualitative content analysis. RESULTS Regarding reasons for seeking support, we created four categories and two subcategories. Main reasons were wanting validation/emotional support and coping strategies for handling the co-parent, and negative perceptions of available support options for SOs. Regarding perceived effects of the program, we created three categories and three subcategories. Main effects were an improved relationship to their children, increased own positive activities, and less adaptation to the co-parent, though SOs also mentioned what was perceived as missing in the program. We argue that the interviewees represent a population of SOs living with co-parents with slightly less severe UAU than previous studies and therefore provide new insights for future interventions. CONCLUSIONS The web-based approach with potential anonymity was important for facilitating support-seeking. Support for the SOs themselves and coping strategies for co-parent alcohol consumption were more common reasons for seeking help than worry about the children. For many SOs, the program was a first step in seeking further support. Spending more dedicated time with their children and being validated as living under stressful conditions were described by the SOs as particularly helpful. Trial registration The trial was pre-registered at isrctn.com, reference number ISRCTN38702517, November 28, 2017.
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Affiliation(s)
- Ola Siljeholm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm Riddargatan 1, 114 35, Stockholm, Sweden. .,Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Veronica Ekström
- grid.412175.40000 0000 9487 9343Department of Social Sciences, Marie Cederschiöld University College, Sköndal, Sweden
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2
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Siljeholm O, Lindner P, Johansson M, Hammarberg A. An online self-directed program combining Community Reinforcement Approach and Family Training and parenting training for concerned significant others sharing a child with a person with problematic alcohol consumption: a randomized controlled trial. Addict Sci Clin Pract 2022; 17:49. [PMID: 36064466 PMCID: PMC9446578 DOI: 10.1186/s13722-022-00332-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an urgent need for interventions helping children affected by parental problematic alcohol consumption (PAC). Such interventions could target partners to individuals with PAC, partners who often themselves show impaired quality of life and mental health. The aim of this study was to investigate the efficacy of an online self-directed intervention combining components from Community Reinforcement Approach and Family Training (CRAFT) with a parenting training program for concerned significant others (CSOs) sharing a child with a co-parent with PAC. METHODS A randomized controlled parallel-group superiority trial compared the efficacy of the online intervention for CSOs sharing a child (3-11 y/o) with a co-parent with PAC (N = 37), to an active control group (N = 39) receiving written psychoeducational material. Assessment of outcomes was conducted at baseline, 3 weeks, 8 weeks and 12 weeks. Primary outcome was children's mental health, while secondary outcomes included parental self-efficacy, CSO mental health and co-parent alcohol consumption and level of dependence. Linear mixed effect models with a factorial time variable were used to model time by group interaction effects. RESULTS Recruitment rate was slow and a vast majority of interested CSOs were excluded at baseline assessment, mainly due experience of co-parent violence. The target sample size was not met. The intention to treat analysis did not show any significant time by group effects on either the primary or secondary outcomes during the follow-up period: the CSOs reported a significant reduction in co-parent alcohol consumption and severity of alcohol dependence and showed significant improvements in parental self-efficacy for how to handle effects of co-parent alcohol consumption, but no differences were found between the two conditions. CONCLUSIONS The current study found no evidence supporting efficacy of a novel, online self-directed intervention on children's mental health, CSO mental health and co-parent alcohol related outcomes. Engaging in a support program or receiving information appears to initiate behavior change in the CSOs which affects the alcohol consumption and severity of dependence for co-parents with PAC. It is suggested that future studies may preferably focus on CSOs in more severely affected contexts. Trial registration The trial was pre-registered at isrctn.com reference number ISRCTN38702517, November 28, 2017.
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Affiliation(s)
- Ola Siljeholm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. .,Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Magnus Johansson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anders Hammarberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Hallgren M, Vancampfort D, Nguyen TTD, Ekblom-Bak E, Wallin P, Andersson G, Lundin A. Physical Activity, Sedentary Behavior, and Cardiorespiratory Fitness in Hazardous and Non-Hazardous Alcohol Consumers. Am J Health Promot 2021; 35:669-678. [PMID: 33406851 PMCID: PMC8165738 DOI: 10.1177/0890117120985830] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose: To describe physical activity habits, sedentary behavior, and
cardiorespiratory fitness levels among alcohol abstainers, hazardous and
non-hazardous drinkers. Design: Cross-sectional study with data collected between 2017-19. Setting: Sweden. Subjects: Adults aged 18-65 years (n = 47,559; 59.4% male). Measures: During a routine health assessment, participants answered validated
single-item questions regarding: habitual physical activity, structured
exercise, and the percentage of time spent sedentary during leisure-time
(past 30 days), and completed a 6-minute cycle ergometer test (V02max) to
determine cardiorespiratory fitness (CRF). Participants were categorized as
alcohol abstainers, non-hazardous drinkers or hazardous drinkers (low/high)
based on the Alcohol Use Disorders Identification Test (AUDIT-C) cut-points
for men and women. Analysis: Logistic regression models stratified by sex and age. Results: Compared to non-hazardous drinkers, the heaviest drinkers were less
physically active (males: OR = 1.38, CI = 1.13-1.67, p = .001; females: OR =
1.41, CI = 1.01-1.97, p = .040) and more sedentary during leisure time
(males: OR = 1.94, CI = 1.62-2.32, p = .000; females: OR = 1.62, CI =
1.21-2.16, p = .001). Apart from young females, the heaviest drinkers also
did less structured exercise than non-hazardous drinkers (males: OR = 1.22,
CI = 1.15-1.51, p = .000; females: OR = 1.43, CI = 1.15-1.78, p = .001). The
strongest associations were seen among adults aged 40-65 years (shown here).
High-hazardous drinking was associated with low CRF among older males only
(OR = 1.19, CI = 1.00-1.41). Conclusion: Middle-aged adults with AUDIT-C scores of ≥6 (women) and ≥7 (men) were less
physically active and more sedentary during leisure time and may be
appropriate targets for physical activity interventions.
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Affiliation(s)
- Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Public Health Sciences, 27106Karolinska Institutet, Stockholm, Sweden
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, University of Leuven; and University Psychiatric Center, Katholieke Universiteit Leuven, Belgium
| | - Thi-Thuy-Dung Nguyen
- Medical Epidemiology and Biostatistics (MEB), 27106Karolinska Institutet, Stockholm, Sweden
| | - Elin Ekblom-Bak
- Astrand Laboratory of Work Physiology, 42750The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Peter Wallin
- Research Department, HPI Health Profile Institute, Danderyd, Sweden
| | - Gunnar Andersson
- Research Department, HPI Health Profile Institute, Danderyd, Sweden
| | - Andreas Lundin
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Public Health Sciences, 27106Karolinska Institutet, Stockholm, Sweden
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O'Brien H, Callinan S, Livingston M, Doyle JS, Dietze PM. Population patterns in Alcohol Use Disorders Identification Test (AUDIT) scores in the Australian population; 2007-2016. Aust N Z J Public Health 2020; 44:462-467. [PMID: 33104260 DOI: 10.1111/1753-6405.13043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/01/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Despite widespread use of the Alcohol Use Disorders Identification Test (AUDIT), there are no published contemporary population-level scores for Australia. We examined population-level AUDIT scores and hazardous drinking for Australia over the period 2007-2016. METHODS Total population, age- and gender-specific AUDIT scores, and the percentage of the population with an AUDIT score of 8 or more (indicating hazardous drinking), were derived from four waves of the nationally representative National Drug Strategy Household Survey, weighted to approximate the Australian population. RESULTS In 2016, the mean AUDIT score was 4.58, and 22.22% of the population scored ≥8. Both measures remained stable from 2007 to 2010 but declined in 2013 and 2016. Scores were highest in those aged 18-24 years, the lowest in those aged 14-17 or 60+. A downward trend in AUDIT scores was seen in younger age groups, while the 40-59 and 60+ groups increased or did not change. CONCLUSIONS Despite an overall decline in AUDIT scores, nearly one-quarter of Australians reported hazardous drinking. Implications for public health: The marked declines in hazardous drinking among young people are positive, but trends observed among those aged 40-59 and 60+ years suggests targeted interventions for older Australians are needed.
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Affiliation(s)
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Victoria
| | | | - Joseph S Doyle
- Burnet Institute, Victoria.,Department of Infectious Diseases, The Alfred and Monash University, Victoria
| | - Paul M Dietze
- Burnet Institute, Victoria.,School of Public Health and Preventive Medicine, Monash University, Victoria.,National Drug Research Institute, Curtin University, Perth, Western Australia
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Källmén H, Berman AH, Elgán TH, Wennberg P. Alcohol habits in Sweden during 1997-2018: a repeated cross-sectional study. Nord J Psychiatry 2019; 73:522-526. [PMID: 31478780 DOI: 10.1080/08039488.2019.1660912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: This study describes changes in alcohol habits in age and gender strata among the Swedish general population during the 21-year period following the Swedish EU membership in 1995. Methods: The Alcohol Use Disorders Identification Test (AUDIT) was distributed as a postal questionnaire to randomly selected cross-sectional samples every fourth year, starting in 1997. Results: Six samples were included in this study. A comparison between 2014 and 2018 showed a tendency to decreasing average total AUDIT scores, particularly among men and in the youngest age group (Cohen's d = 0.28). Conclusion: The results should be understood in the context of declining response rates in this type of survey.
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Affiliation(s)
- Håkan Källmén
- Stockholm Prevents Alcohol and Drug Problems (STAD) , Stockholm , Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Anne H Berman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden.,Department of Public Health Sciences, Stockholm University , Stockholm , Sweden
| | - Tobias H Elgán
- Stockholm Prevents Alcohol and Drug Problems (STAD) , Stockholm , Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Peter Wennberg
- Department of Public Health Sciences, Stockholm University , Stockholm , Sweden.,Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
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Lindner P, Siljeholm O, Johansson M, Forster M, Andreasson S, Hammarberg A. Combining online Community Reinforcement and Family Training (CRAFT) with a parent-training programme for parents with partners suffering from alcohol use disorder: study protocol for a randomised controlled trial. BMJ Open 2018; 8:e020879. [PMID: 30099390 PMCID: PMC6089295 DOI: 10.1136/bmjopen-2017-020879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Partners and children of individuals with alcohol use disorder (AUD) present with impaired quality of life and mental health, yet seldom seek or participate in traditional supportive interventions. Engaging the parent/partner without AUD in treatment is a promising way of supporting behavioural change in both the child and the parent with AUD. Universal parent-training (PT) programmes are effective in increasing children's well-being and decreasing problem behaviours, but have yet to be tailored for children with a parent with AUD. Community Reinforcement Approach And Family Training (CRAFT) programmes are conceptually similar, and aim to promote behavioural change in individuals with AUD by having a concerned significant other change environmental contingencies. There has been no study on whether these two interventions can be combined and tailored for partners of individuals with AUD with common children, and delivered as accessible, online self-help. METHODS AND ANALYSIS: n=300 participants with a child showing mental health problems and partner (co-parent) with AUD, but who do not themselves present with AUD, will be recruited from the general public and randomised 1:1 to either a four-module, online combined PT and CRAFT programme or a psychoeducation-only comparison intervention. Primary outcome will be the child's mental health. Additional outcomes will cover the partner's drinking, the participants own mental health and drinking, the child's social adjustment, treatment seeking in all three parties and parental self-efficacy. Measures will be collected preintervention, mid-intervention and postintervention, and three times during a 2-year follow-up period. Data will be analysed using mixed-effects modelling. ETHICS AND DISSEMINATION This study has been approved by the Stockholm Regional Ethical Review Board (2016/2179-31). The results will be presented at conferences and published as peer-reviewed publications. TRIAL REGISTRATION NUMBER ISRCTN38702517; Pre-results.
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Affiliation(s)
- Philip Lindner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Ola Siljeholm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Magnus Johansson
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Martin Forster
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sven Andreasson
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hammarberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Abstract
Purpose This observational study examined user characteristics, intervention use patterns, and variables associated with reductions in alcohol consumption for anonymous Internet help-seekers using a Web-based self-help program. Method A Web-based cognitive behavioral therapy (CBT) program with eight modules delivered over 10 weeks was offered to participants with at least hazardous use of alcohol according to the Alcohol Use Disorders Identification Test (AUDIT) (n = 4165). At baseline and 10-week follow-up, participants completed the Timeline-followback (TLFB), AUDIT, Drug Use Disorders Identification Test (DUDIT), Hospital Anxiety and Depression Scale (HADS), EuroQol-5 dimension (EQ-5D), World Health Organization Quality of Life Scale-abbreviated version (WHOQOL-BREF), Readiness to Change Questionnaire (RCQ), and Readiness Ruler. Follow-up completers and non-completers were compared at baseline, and follow-up completer outcomes were reported. Predictors of change in drinking behavior were evaluated at follow-up. Results Registered users were 41.88 years old on average (SD = 12.36), and 52 % were women; the mean baseline number of drinks during the past week was 27.27 (SD = 17.92) with 62 % in the AUDIT category of probable dependence and only 7 % having low-risk consumption according to public health guidelines. At follow-up (n = 1043), 53 % showed a clinically significant change to a lower level of alcohol use (χ2 = 254.403, p < 0.001); the mean alcohol consumption fell (t = 22.841, p < 0.001) and the proportion with low-risk consumption rose to 40 %. Being male, scoring higher on baseline readiness, completing the program, and accessing other support predicted low-risk drinking and clinically significant change to a lower level of alcohol use at follow-up. Conclusion A publicly available Web-based program for managing problematic alcohol use attracted users with considerable alcohol- and health-related problems, which were changed to lower severity for follow-up completers.
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Bock D, Angenete E, Gonzales E, Heath J, Haglind E. Assessing health, quality of life and urogenital function in a sample of the Swedish general population: a cross-sectional study. BMJ Open 2018; 8:e021974. [PMID: 29730632 PMCID: PMC5942440 DOI: 10.1136/bmjopen-2018-021974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Evaluate the urinary, bowel and sexual function as well as stress symptoms and depression in a sample of the Swedish population. DESIGN A random sample of Swedish men and women in age groups from 30 to 89 years, a total of 3000 individuals, were contacted and after receiving informed consent, a questionnaire was sent. MAIN OUTCOME MEASURES Measures of urinary, bowel, sexual function and quality of life. RESULTS The questionnaire was sent to 2094 individuals who gave informed consent. The questionnaire was answered by 1078 individuals. Quality of life, stress symptoms and depressed mood were relatively constant across age groups for both men and women. Urinary function differed significantly across gender and age groups, but bowel function was relatively unaffected by age. Overall bowel dysfunction was slightly more prevalent among women compared with men. For both men and women, the frequency of intercourse or other sexual activities decreased with age, whereas sexually associated distress increased by age in men, but decreased among women. CONCLUSIONS In a general population, the urinary function varied across age and sex. Overall bowel dysfunction was slightly more prevalent among women compared with men. Sexually associated distress increased by age for men, but decreased for women. TRIAL REGISTRATION NUMBER NCT02392923; Results.
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Affiliation(s)
- David Bock
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Scandinavian Surgical Outcomes Research Group (SSORG), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
- Health Metrics Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Scandinavian Surgical Outcomes Research Group (SSORG), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Elisabeth Gonzales
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Scandinavian Surgical Outcomes Research Group (SSORG), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Jane Heath
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Scandinavian Surgical Outcomes Research Group (SSORG), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Eva Haglind
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Scandinavian Surgical Outcomes Research Group (SSORG), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
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Bock D, Angenete E, Bjartell A, Carlsson S, Steineck G, Stranne J, Thorsteinsdottir T, Wiklund P, Haglind E. Habits and self-assessed quality of life, negative intrusive thoughts and depressed mood in patients with prostate cancer: a longitudinal study. Scand J Urol 2017. [DOI: 10.1080/21681805.2017.1326523] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- David Bock
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG (Scandinavian Surgical Outcomes Research Group), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
- Health Metrics Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG (Scandinavian Surgical Outcomes Research Group), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Stefan Carlsson
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Steineck
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Johan Stranne
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden
| | | | - Peter Wiklund
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Eva Haglind
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG (Scandinavian Surgical Outcomes Research Group), Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
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Warne M, Sinadinovic K, Berman AH, Källmén H, Vinberg S. Risky consumption of alcohol and drugs among employees at ski resorts. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017; 34:201-216. [PMID: 32934485 PMCID: PMC7450871 DOI: 10.1177/1455072517707879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 04/07/2017] [Indexed: 12/03/2022] Open
Abstract
AIM To evaluate risky consumption of alcohol and drugs among Swedish men and women who are employed at ski resorts. METHODS A cross-sectional sample of 611 employees in 48 small and medium-sized enterprises responded to a questionnaire covering alcohol and drug use, social aspects around work and working conditions. Consumption of alcohol and drugs in the study sample was compared to population data. Data were analysed using Mann-Whitney U-tests and logistic regression analyses. RESULTS Compared to the general population, the study group of ski resort employees had higher scores on the Alcohol Use Disorders Identification Test (AUDIT) in all age groups except 35+ for men. Regarding the Drug Use Disorders Identification Test (DUDIT) scores, only men in the 18-24 age group had higher scores compared to the general population. The prevalence of risky alcohol and drug use was higher among seasonally employed individuals; 82.9%, compared to 58.0% among other employees for alcohol; 8.3% compared to 2.8% for drugs. The regression analysis indicated that social aspects such as living together with colleagues and having co-workers/friends who are frequently inebriated were the most significant explanatory variables for explaining risk consumption of alcohol (OR 16.82 and OR 4.33). Risky use of drugs was associated with being younger (OR 0.15) and male (OR 0.86), as well as with having co-workers/friends who are frequently inebriated (OR 4.25). CONCLUSIONS The study showed a high prevalence of risky alcohol consumption among ski resort employees compared to the general population, with higher risky drug consumption found only among younger men. Social aspects such as living with colleagues and having co-workers or friends who are often inebriated, were identified as important explanatory factors. Preventive measures should be introduced, targeting norms and work culture surrounding alcohol and drug use among ski resort employees.
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Affiliation(s)
| | | | | | - Håkan Källmén
- STAD, Centre for Psychiatry Research, Stockholm, Sweden
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11
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Hammarberg A, Öster C, Nehlin C. Drinking motives of adult patients seeking treatment for problematic alcohol use. J Addict Dis 2017; 36:127-135. [PMID: 28166486 DOI: 10.1080/10550887.2017.1291052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Drinking Motives Questionnaire measures motives for alcohol consumption on four subscales. Coping with negative affect and enhancement of positive affect have been shown to be associated with high levels of alcohol consumption and alcohol-related problems. Few studies exist concerning drinking motives among treatment-seeking patients. The aims of the study were to investigate the factor structure of the shortened-form of the revised Drinking Motives Questionnaire, map main drinking motives, explore group differences in motives due to sex, age, level of drinking problems, and symptoms of depression/anxiety and to investigate whether different drinking motives predict alcohol-related problems in this group. There were 274 treatment-seeking patients recruited from four addiction treatment clinics in Sweden. The shortened-form of the revised Drinking Motives Questionnaire was administered in conjunction with a regular visit to the clinics together with measures of degree of alcohol-related problems, psychiatric symptoms, and demographic factors. Main drinking motives were identified. A confirmatory factor analysis was run to confirm the factor structure of the shortened-form of the revised Drinking Motives Questionnaire. A logistic regression using the Enter method was performed to investigate associations between predictors and Alcohol Use Disorder Identification Test scores. The results confirmed the four-factor structure reported in studies on non-treatment-seeking individuals. Coping was the most commonly expressed motive. Not previously found in a clinical sample, the results showed that coping motives, together with being male and having elevated anxiety scores, were associated to Alcohol Use Disorder Identification Test scores indicative of alcohol dependence. The shortened-form of the revised Drinking Motives Questionnaire is a brief and valid instrument that holds potential for clinical use in mapping drinking motives among treatment seekers.
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Affiliation(s)
- Anders Hammarberg
- a Centre for Psychiatry Research, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden.,b Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Caisa Öster
- c Uppsala University , Department of Neuroscience , Psychiatry.,d Uppsala University Hospital , Sweden
| | - Christina Nehlin
- c Uppsala University , Department of Neuroscience , Psychiatry.,d Uppsala University Hospital , Sweden
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12
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Larsson K, Nehlin C. Screening accuracy of brief alcohol screening instruments in a general hospital setting. Scand J Public Health 2016; 44:599-603. [DOI: 10.1177/1403494816651779] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/16/2022]
Abstract
Aim: The aim of this study was to examine the screening accuracy of four brief alcohol screening instruments in a general hospital setting. Methods: Ten outpatient clinics were recruited to ensure a representative mix of demographics (e.g. sex, age and diagnosis). The staff at the reception desk handed out pre-sorted envelopes with questionnaires and information letters to the visitors. The questionnaires consisted of the 10-item Alcohol Use Disorders Identification Test (AUDIT), the Weekly Consumption Question (WCQ), the Heavy Episodic Drinking (HED) question and two questions on sex and age. Sensitivity and specificity were calculated for the AUDIT-C, AUDIT-3, WCQ and HED using the full 10-item AUDIT for comparison, with cut-off points of ⩾6 for women and ⩾8 for men. Results: In all, 898 questionnaires were included (52% women). According to the full AUDIT, 12.0% of the women and 14.8% of the men were drinking above the hazardous level. Corresponding percentages for the brief screening instruments for women and men, respectively, were as follows: AUDIT-C: 17.2% and 27.4%; the AUDIT-3: 6% and 16.2%; the WCQ: 2% and 1.6%; and the HED screener: 12.9% and 21.2%. Conclusions: The AUDIT-C may be used as a brief screener in a general hospital setting. The WCQ, as a stand-alone screening tool, may underestimate hazardous drinking habits. Screening results from the AUDIT-3 and the HED should be interpreted with caution when applied to women because of the risk of underestimation.
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Affiliation(s)
- Kjerstin Larsson
- Department of Public Health and Caring Sciences, Section of Social Medicine and Epidemiology, Uppsala University, Sweden
- Department of Neurobiology, Care Sciences and Society, Section of Social Work, Karolinska Institutet, Sweden
| | - Christina Nehlin
- Department of Neuroscience, Psychiatry; Uppsala University, Sweden
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Åhlin J, Hallgren M, Öjehagen A, Källmén H, Forsell Y. Adults with mild to moderate depression exhibit more alcohol related problems compared to the general adult population: a cross sectional study. BMC Public Health 2015; 15:542. [PMID: 26051511 PMCID: PMC4459061 DOI: 10.1186/s12889-015-1837-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 05/13/2015] [Indexed: 12/12/2022] Open
Abstract
Background Alcohol use has been shown to interfere with treatment for depression, but consumption habits are not routinely screened in primary care. To date, few studies have compared the alcohol consumption habits of patients with depression to the general population. The purpose of this study was to compare alcohol habits in adults diagnosed with depression in primary care to the general adult population in Sweden. Methods Nine hundred fourty six patients diagnosed with mild to moderate depression, without a primary substance use disorder, in primary care settings located across Sweden completed the Alcohol Use Disorders Identification Test (AUDIT). Consumptions habits and alcohol related problems in the depressed sample were compared to those in the general adult population (n = 663). Analyses were stratified by gender and age. Results Ratings of alcohol problems and measures of hazardous drinking and binge drinking were significantly higher among patients seeking treatment for depression in primary care compared to the general population. Male patients scored higher on the AUDIT total and AUDIT-C (consumption) subscale than men in the general population. Compared to younger adults (aged 17–27) older depressed adults (aged 28–50 and 51–71) exhibited higher rates of consumption and problems related to alcohol. Conclusions Compared to the general adult population, consumption and problems related to alcohol use were substantially higher among patients with mild to moderate depression in primary care. Routine screening of alcohol use in primary care is recommended for patients presenting with depression.
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Affiliation(s)
- Julia Åhlin
- Department of Public Health Sciences, Section for Epidemiology and Public Health Intervention Research (EPHIR), Karolinska Institutet, Stockholm, Sweden.
| | - Mats Hallgren
- Department of Public Health Sciences, Section for Epidemiology and Public Health Intervention Research (EPHIR), Karolinska Institutet, Stockholm, Sweden.
| | - Agneta Öjehagen
- Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden.
| | - Håkan Källmén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,STAD, Centre for Psychiatry research, Stockholm, Sweden.
| | - Yvonne Forsell
- Department of Public Health Sciences, Section for Epidemiology and Public Health Intervention Research (EPHIR), Karolinska Institutet, Stockholm, Sweden.
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