Objective: Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment. Methods: This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment. Results: Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjusted Conclusion A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.
Aged ; Aged, 80 and over ; Alcohol Abstinence ; Alcohol Drinking ; China ; Cognition ; Cognitive Dysfunction/epidemiology* ; Female ; Health Behavior ; Humans ; Longitudinal Studies ; Male ; Mental Status and Dementia Tests ; Risk

OBJECTIVE: This study aimed to compare the bone mineral density of male patients with alcohol dependence with that in healthy controls and to assess changes in bone density after abstinence. METHODS: Forty-four inpatients with confirmed the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis of alcohol abuse and 42 controls were recruited. Bone density was determined with dual-energy X-ray absorptiometry in the lumbar spine as well as in the femoral neck, trochanter, and Ward’s triangle regions of the proximal right femur. RESULTS: There were no significant differences in age and body mass index between patients with alcohol dependence and healthy controls. In the alcohol dependence group, osteopenia and osteoporosis were found in 54.5% and 34.1% of the patients, respectively, whereas in the control group, the corresponding values were 45.2% and 11.9% (p=0.001). Although the actual bone density in the femur and the corresponding T-scores were significantly lower in the alcohol dependence group, no significant differences were found in the lumbar spine. In both groups, body mass index showed a significant correlation with bone mineral density in all areas. After 3 to 4 years of abstinence, bone density significantly increased in the lumbar and femur. CONCLUSION: We conclude that bone mineral density in patients with alcohol dependence was significantly lower than that in healthy controls, and the rates of osteopenia and osteoporosis are higher. Importantly, abstinence from alcohol increases bone density.
Absorptiometry, Photon ; Alcohol Abstinence ; Alcoholism* ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Femur ; Femur Neck ; Humans ; Inpatients ; Male* ; Osteoporosis ; Spine

OBJECTIVE: The aim of this study was to examine the reliability and validity of the Korean version of the Impaired Control Scale (K-ICS), a scale to screen patients with alcohol use disorder. METHODS: Participants were 173 inpatients with alcohol use disorder (AUD), and 174 normal controls (NC). Both AUD and NC groups completed the K-ICS as well as the Alcohol Dependence Scale (ADS), the Alcohol Abstinence Self-Efficacy Scale (AASES), the Brief Self-Control Scale (BSCS), and the Hospital Anxiety and Depression Scale (HAD). RESULTS: The internal consistencies of K-ICS were good in both AUD and NC. A good convergent validity was clearly shown by significant correlations with the ADS and the AASES, respectively. But the K-ICS had no or weak correlations with the BSCS and the HAD. The ROC curve analyses indicated that the optimal cut-off points of failed control (FC) and predicted control (PC) were estimated as >15 and >13, respectively. Hierarchical multiple regression analysis suggested that FC is a robust predictor of the severity of AUD. CONCLUSION: The K-ICS, especially FC subscale of it appears to be a valid and reliable measure of impaired control among both clinical and non-clinical sample.
Alcohol Abstinence ; Alcoholism ; Anxiety ; Depression ; Humans ; Inpatients ; Reproducibility of Results* ; ROC Curve ; Self-Control

Severe acute alcoholic liver disease (SAAH) unresponsive to medical therapy shows one-year-mortality rates of up to 90%. Most transplant centers request six months of alcohol abstinence prior to transplantation, the so-called “6-month rule.” This regulation is not based on strong evidence, repeatedly making it a topic of controversial debates. The majority of patients with SAAH will die before fulfilling the 6-month rule. Therefore, liver transplantation (LT) protocols are becoming more flexible towards the rigid abstinence regulation, especially concerning SAAH patients. We conducted a literature review regarding LT in SAAH and its outcomes, including post-transplant mortality and recidivism. We studied available data on PubMed from 2011 and onwards whilst including articles dealing with genetic components, medical therapy and historic snapshots of alcoholism. Emerging studies recommend LT in SAAH not responding to medical therapies even without realizing the required abstinence period, since the majority of these patients would die within 6 months. SAAH without response to medical therapy has one-year-mortality rates of up to 90%. The 6-month rule is not based on strong evidence and is repeatedly a topic of controversial debates. There is genetic linkage to alcoholism and medical therapy is not as effective as estimated, yet. The 6-months-regulation has not shown to evidently decrease the risk of recidivism post-LT, which is a lifesaving treatment in SAAH patients. Insisting on rigid sobriety rules results in excluding patients with a low risk of recidivism from being transplanted. Moreover, the genetic linkage of alcoholism must be recognized.
Alcohol Abstinence ; Alcoholics* ; Alcoholism ; Carcinoma, Hepatocellular ; Fibrosis ; Genetic Linkage ; Hepatitis, Alcoholic* ; Humans ; Liver Diseases, Alcoholic ; Liver Failure ; Liver Transplantation ; Liver* ; Mortality

PURPOSE: The study investigated whether neurofeedback training (NFT) can normalize the excessive high beta and low alpha waves indicative of hyperarousal and subsequently improve autonomous regulation based on the self-determination theory in alcohol use disorders. METHODS: A nonequivalent control group preteste-posttest design was used. Data were collected using self-report questionnaires from 36 Korean inpatients who met the Alcohol Use Disorder Identification Test in Korea criteria. Data were collected from quantitative electroencephalography to assess alpha (8–12 Hz) and high beta (21–30 Hz) waves for hyperarousal. The questionnaires included Basic Psychological Need Satisfaction scales that assessed autonomy, competence, and relatedness, and the Alcohol Abstinence Self-Efficacy Scale and Treatment Self-Regulation Questionnaire. The experimental group underwent 10 sessions of NFT over 4 weeks. Data were analyzed using the Chi-squared, Manne-Whitney U, and Wilcoxon signed-rank tests. RESULTS: In the experimental group, the alpha wave was increased in 15 of 19 sites and high beta waves were decreased in 15 of 19 sites, but this difference was not significant. However, high beta waves were increased in 15 of 19 sites in the control group, with seven sites (Fz, Cz, Pz, Fp2, F4, C4, and P4) showing significant increases. The experimental group showed a significant increase in basic psychological need satisfaction, alcohol abstinence self-efficacy, and self-regulation compared with the control group. CONCLUSION: NFT is recommended for improving autonomous regulation in alcohol use disorder as a nursing intervention. However, for significantly attenuating hyperarousal through brain wave correction, it may be necessary to increase the number of neurofeedback sessions.
Alcohol Abstinence ; Alcoholism ; Brain Waves ; Electroencephalography* ; Humans ; Inpatients ; Korea ; Mental Competency ; Neurofeedback* ; Nursing ; Self-Control ; Social Control, Formal* ; Weights and Measures

PURPOSE: The purpose of this study was to explore the subjective experiences of those who are abstinent from alcohol to recover from alcoholism. METHODS: A qualitative descriptive study design was used. RESULTS: In this study, 3 clusters of themes and 7 themes were derived: 1. Decision for abstinence - 1) an unavoidable choice and 2) choice due to insight to alcoholism; 2. Difficulties to endure - 1) difficulty with giving up and 2) difficulty with handling; 3. Adaptation to a new lifestyle - 1) satisfaction with trivial rounds of daily life, 2) finding new values, and 3) restoration of broken relationships. CONCLUSION: Abstinence experience among people with alcohol use disorder is decided with a variety of personal motives. Abstinence experience includes giving up relationships with people and pleasure with alcohol as well as difficulties with enduring stress without alcohol. However, participants who were abstinent from alcohol were satisfied with their new lifestyles, had new life values, and were respected by their family and others. Therefore, healthcare providers needed to understand abstinence experience to support people with alcohol use disorder who have passed through a difficult process of alcohol abstinence.
Alcohol Abstinence ; Alcoholics ; Alcoholism ; Health Personnel ; Humans ; Life Style ; Male ; Pleasure ; Qualitative Research

Spontaneous regression of hepatocellular carcinoma (HCC) is associated with alcohol abstinence, herbal medication, radiation, ischemia and immune reaction against systemic or local infections. Herein, we report a case of 67-year-old man with spontaneous disappearance of HCC after local infection as a rare cause. The patient had no clinical symptoms except for markedly increased tumor marker of HCC (protein induced by vitamin K absence or antagonist-II: 731 mAU/mL). On computed tomography (CT) and magnetic resonance imaging, massive infiltrating HCC with portal vein invasion was confirmed. During conservative treatment, he was admitted due to suppurative diabetic foot. After medical treatment, HCC disappeared on follow-up CT scans, along with change in hepatic contour. The disappearance of HCC might be a result of immune response by treatment of the diabetic foot and that of ischemia by portal vein tumor thrombosis secondarily. We summarized case reports regarding spontaneous regression of HCC by infection and ischemia.
Aged ; Alcohol Abstinence ; Carcinoma, Hepatocellular ; Diabetic Foot ; Follow-Up Studies ; Humans ; Ischemia ; Magnetic Resonance Imaging ; Neoplasm Regression, Spontaneous ; Portal Vein ; Thrombosis ; Tomography, X-Ray Computed ; Vitamin K

BACKGROUND/AIMS: In recent years, the incidence of acute pancreatitis (AP) has been increasing. A better understanding of the etiology is directly linked to more favorable outcomes. Unfortunately, there have been reports suggesting the variation of etiologies of AP across countries. The objective of this study was to determine the etiology of AP in a general hospital of Seoul-Gyeonggi province in Korea during the past decade. METHODS: We retrospectively reviewed the medical records of consecutive patients with AP who were admitted to St. Paul's Hospital (Seoul, Korea) with an affiliation to the Catholic University of Korea between January 2003 and January 2013. RESULTS: A total of 1,110 patients were enrolled, totaling 1,833 attacks, and the most frequent cause of AP was alcohol consumption. The recurrence rate of AP was 24.5% (272/1,110), and habitual recurrence rate (more than three times) was 12.6% (140/1,110). The rate of severe AP was 4.9% (90/1,833 attacks). The mortality rate of AP was 2.6% (29/1,110 patients). The frequency of an idiopathic cause of AP was 13.3%. The recurrence rate and mortality rate of idiopathic AP were 16.2% and 5.4%, respectively. In 41.7% (10/24) of cases of idiopathic AP, microlithiasis was suspected. CONCLUSIONS: Between 2003 and 2013 in Korea, alcohol was the most frequent cause of AP in the general hospital of Seoul-Gyeonggi province of Korea. It appears that alcohol abstinence program may be necessary. Further nationwide studies would be needed to evaluate the etiologies of AP.
Alcohol Abstinence ; Alcohol Drinking ; Alcohols ; Gallstones ; Hospitals, General* ; Humans ; Incidence ; Korea* ; Medical Records ; Mortality ; Pancreatitis* ; Recurrence ; Retrospective Studies

OBJECTIVES: Alcohol use disorder (AUD) is closely associated with attention-deficit/hyperactivity disorder (ADHD). However, the mechanism involved in this association remains unclear. Impulsivity is one of the core traits of ADHD, and an elevated level of impulsivity increases the risk of onset of AUD. Our study focused on impulsivity as the common trait factor of these disorders. We examined the effects of ADHD symptoms and impulsivity on the abstinence period of patients with AUD. METHODS: Male participants with AUD completed the contents of the Adult ADHD Self-Report Scale and the Barratt Impulsiveness Scale. We investigated participant alcohol abstinence period to evaluate severity and frequency of relapse. RESULTS: Both ADHD symptom presence and abstinence period were significantly correlated with impulsivity. Motor impulsivity showed the highest correlations with ADHD and abstinence. The results of hierarchical regression analysis showed that impulsivity is a predictor of abstinence period, while ADHD had a moderating effect on the relationships between impulsivity and abstinence period. Moreover, we undertook hierarchical regression analysis of motor, cognitive, and non-planning impulsivity ; only motor impulsivity and ADHD symptom showed a statistically significant interaction with abstinence period. CONCLUSION: The results indicate a possible causal relationship between the treatment of ADHD symptoms and the extension of AUD abstinence period. In other words, treatment of ADHD symptoms may prevent AUD relapse. Impulsivity, especially motor impulsivity has an important role in the base mechanisms of these two disorders.
Adult ; Alcohol Abstinence ; Humans ; Impulsive Behavior* ; Male* ; Recurrence

PURPOSE: The purpose of this study was to identify the factors affecting social problem-solving ability in alcohol dependent men in outpatient treatment facilities. METHODS: Participants were 148 men dependent on alcohol who were outpatients at 5 hospitals for mentally ill patients in G City. Data were collected from May 1 to June 30, 2016 using self-report questionnaires. Abstinence self-efficacy, existential spiritual well-being, alcohol insight, unconditional self-acceptance, and social problem-solving ability were investigated. For data analysis t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression were employed. RESULTS: Mean score for social problem-solving ability was 18.28±5.27. Social problem-solving ability had a positive correlation with abstinence self-efficacy, existential spiritual well-being, and unconditional self-acceptance. Factors affecting social problem-solving ability in these men were unconditional self-acceptance, lack of sleep disorder, existential spiritual well-being, and religiousness. The explanatory power was 57%. CONCLUSION: In planning an intervention for social problem-solving ability for alcohol dependent men, it is important to employ strategies which provide enhancement of self-acceptance as a healthy countermeasure to the low level of unconditional self-acceptance and to provide educational interventions for physical health or sleep deprivation for the patients with these problems along with low social problem-solving ability.
Alcohol Abstinence ; Alcoholics ; Humans ; Male* ; Mentally Ill Persons ; Outpatients ; Problem Solving ; Sleep Deprivation ; Sleep Wake Disorders ; Statistics as Topic