Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study

BACKGROUND AND AIMS

Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs).

DESIGN

We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first.

SETTING

Denmark.

PARTICIPANTS

Respondents (n = 4522) from a Danish national survey conducted in autumn 2011.

MEASUREMENTS

Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT-C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder.

FINDINGS

During the study period, 56 respondents had a first-time ARDD admission. Respondents who scored above the 8-point AUDIT cut-off and respondents who scored above the 5-point AUDIT-C cut-off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut-offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59-8.60; AUDIT-C: HR, 7.97; 95% CI, 3.66-17.31).

CONCLUSIONS

Scores above alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) cut-offs are associated with an increased risk of long-term alcohol-related hospital admissions. At widely used cut-offs, the AUDIT-C is a better predictor of alcohol-related hospitalizations among members of the general population than the full AUDIT.

Hazardous drinking and violence-related hospitalizations in the Danish general population: A historical cohort study

BACKGROUND

It is well documented by case-control and case-crossover studies that hazardous drinking and the risk of experiencing violence-related injuries are related. The present study investigated this relationship in a cohort of general population survey respondents in Denmark using subsequent hospital admissions for violence.

METHODS

The cohort consisted of participants in the 2011 Danish national survey on alcohol and drugs (N = 5126). Survey responses were used to identify those with hazardous alcohol use. Register data on the cohort's hospital admissions for violence from 2010 through 2018 served as the outcome. The relationship between respondents' hazardous drinking and counts of subsequent hospital admissions was investigated using a Poisson regression model.

RESULTS

After controlling for confounding, respondents with hazardous consumption (Alcohol Use Disorders Identification Test Consumption [AUDIT-C] cut off: 5 points) had an increased rate of hospital admissions for violence, with an incidence rate ratio (IRR) of 2.28 (95% CI: 1.16-4.50) compared to respondents without hazardous alcohol use. Each additional AUDIT-C point was associated with a 20% increase in the incidence rate for violence-related admission (IRR=1.20, 95% CI: 1.06-1.37). Furthermore, interaction analyses showed a significant interaction between gender and AUDIT-C score on hospital admissions for violence (IRR=0.69, 95% CI: 0.53-0.90).

CONCLUSIONS

Results provide evidence that hazardous alcohol use is associated with subsequent hospital admissions for violence in the Danish general population and that gender moderates this relationship.

The impact of parental substance use disorder and other family-related problems on school related outcomes

Aims

To identify young people with different levels of family-related problems, including parental substance use disorder (PSUD), and investigate differences in grades at graduation from compulsory school and further enrollment in education.

Methods

Participants included 6784 emerging adults (aged 15-25 years) from samples drawn for two national surveys in Denmark 2014-2015. Latent classes were constructed using the following parental variables: PSUD, offspring not living with both parents, and parental criminality, mental disorders, chronic diseases and long-term unemployment. The characteristics were analyzed using an independent one-way ANOVA. Differences in grade point average and further enrollment were analyzed using linear regression and logistic regression, respectively.

Results

Four classes of families were identified: 1. "Low adverse childhood experiences (ACE) families", 2. "Families with PSUD", 3. "Families with unemployment" and 4. "High ACE families". There were significant differences in grades, with the highest average among youth from "Low ACE families" (males = 6.83; females = 7.40) and significant lower averages among both males and females from the other types of families, but lowest among young people from "High ACE families" (Males = 5.58; females = 5.79). Youth from "Families with PSUD" (Males: OR = 1.51; 95% CI: 1.01-2.26; females: OR = 2.16; 95% CI: 1.22-3.85) and "High ACE families" (Males: OR = 1.78; 95% CI: 1.11-2.26) were significantly more likely not to be enrolled in further education compared with "Low ACE families".

Conclusions

Young people who experience PSUD, both as the primary family-related problem as well as among multiple family-related problems, are at increased risk for negative school-related outcomes.

Changes in Alcohol Use in Denmark during the Initial Months of the COVID-19 Pandemic: Further Evidence of Polarization of Drinking Responses

INTRODUCTION

The year 2020 was marked by the COVID-19 pandemic. Policy responses to COVID-19 affected social and economic life and the availability of alcohol. Previous research has shown an overall small decrease in alcohol use in Denmark in the first months of the pandemic. The present paper focused on identifying which subgroups of individuals had decreased or increased their consumption.

MATERIALS AND METHODS

Data were collected between May and July 2020 (n = 2,566 respondents, convenience sample). Weights were applied to reflect the actual Danish general population. Variables included the pre-pandemic alcohol consumption, change in alcohol consumption in the past month, socio-demographics, and reported economic consequences. Responses to a single item assessing changes in alcohol consumption in the past month were classified as no change, increase, or decrease in consumption. Regression models investigated how changes in consumption were linked to pre-pandemic drinking levels, socio-demographics (gender, age groups, education), and reported economic consequences.

RESULTS

While 39% of participants reported decreased consumption levels and 34% had stable levels, 27% increased consumption. Characteristics associated with changes in consumption were associated with both increases and decreases in consumption: younger people, those with higher consumption levels before the pandemic, and those with lower education more often both reported increases as well as decreases in consumption.

DISCUSSION/CONCLUSIONS

We confirmed that more people decreased rather than increased their alcohol consumption in the first few months of the pandemic in Denmark. Characteristics associated with changes in consumption such as younger age, higher consumption levels, and lower education demonstrated a polarization of drinking since these were associated with both increases and decreases in consumption. Public health authorities should monitor alcohol use and other health behaviours for increased risks during the pandemic.

How Do Register-Based Studies Contribute to Our Understanding of Alcohol's Harms to Family Members? A Scoping Review of Relevant Literature

OBJECTIVE

This review maps the research literature on register-based studies of alcohol's harms to family members and identifies areas for future research.

METHOD

Using a scoping review methodology, the PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched in August 2019 with keywords to identify studies that included register-based outcome sources, a family relationship, and an exposure to heavy drinking. In total, 5,961 records were screened, 403 full-text articles were assessed for eligibility, and 91 studies were included in the final review.

RESULTS

Register-based research on alcohol's harms to family members has largely drawn on hospital records to identify heavy drinkers and has primarily focused on children of heavy drinkers; 79 of the included studies solely investigated harms to children, whereas 2 focused on partners and 10 on multiple first-degree or unspecified relatives. Register-based studies show that children of heavy drinkers are at a higher risk for mental disorders, disease and injury hospitalizations, infant and child mortality, criminality, poor employment and educational outcomes, abuse/neglect, and placement in residential/foster care, among other negative outcomes.

CONCLUSIONS

A substantial body of register-based research shows that children of parents with the most severe alcohol problems are at an increased risk for numerous adverse experiences. Register-based studies have investigated diverse, yet precisely defined outcomes, using large samples followed over long periods, and have examined the contribution of genetic, biological, and environmental factors. Our understanding of alcohol's harms to families could be enhanced by further register-based research on other household family members of heavy drinkers.

A comparison of four telephone-based counseling styles for recovering stimulant users

The continuing development and refinement of empirically supported interventions to increase participation in posttreatment care and promote sustained abstinence from illicit drug use is a priority for the addictions field. The purpose of this study was to assess the combined and relative effectiveness of four types of counseling styles, delivered by telephone, relative to a no call control condition. Stimulant users (N = 302) were randomized to one of four low-cost, telephone support protocols (unstructured/nondirective, unstructured/directive, structured/nondirective, structured/directive) or a standard referral to aftercare without telephone counseling (control). All of the study participants were nearing the completion of (or had completed) an intensive phase of structured, outpatient stimulant abuse treatment. Drug use and aftercare participation were assessed at 3 and 12 months following randomization. Intent-to-treat analyses showed no significant time-by-group interactions for these primary outcomes. Subsequent analyses, however, revealed a significant difference between the aggregated call groups and the control group at the time of the 3-month follow-up. The mean ASI drug use severity composite score for subjects in the call conditions declining from .058 at baseline to .048 at 3 months, whereas the no call/control group average score increased from .053 to .062 (χ (1) = 4.95, p = .026). A similar-and slightly stronger-effect was found when the study sample was restricted to those reporting any use during the month prior to the baseline interview (n = 152). This study provides modest support for the telephone-based counseling approaches strategies examined in this project. Subsequent research will assess interactions between patient characteristics and counseling styles, and improved identification of which treatment graduates might be more likely to benefit from this type of continuing support. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Use of a personal computer for fast acquisition of cardiovascular data over an extended period

This paper describes data collection during open chest cardiovascular research based on an IBM compatible personal computer. Data from eight analogue data channels are collected at a rate of 500 Hz per channel for a period of more than 40 sec per run. General analysis functions include the integration of the data obtained from any channel as well as an exponential curve fitting routine. Special functions are available for the calculation of cardiac parameters. This includes the automatic determination of end-diastole and end-systole, as well as maximum and minimum values of all curves for both the systolic and diastolic phases of contraction.