The influence of hazardous drinking on psychological functioning, stress and sleep during and after treatment in patients with mental health problems: a secondary analysis of a randomised controlled intervention study

Strid, Catharina; Andersson, Claes; Öjehagen, Agneta

doi:10.1136/bmjopen-2017-019128

Cited by 16 publications

(7 citation statements)

References 35 publications

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“…The current emphasis on ensuring support is available for both the Armed Forces and Police Forces should continue, through ‘active monitoring’ for those who have been exposed to trauma and further help being accessible to those who need it (Greenberg, Megnin-Viggars, & Leach, 2019 ). Further, a brief screen for harmful alcohol use should be integrated with mental health support, as those who use alcohol to cope may experience further mental health decline (Strid, Andersson, & Öjehagen, 2018 ), which is particularly important for military personnel, given the higher rates of harmful drinking and comorbid PTSD and harmful drinking.…”

Section: Discussionmentioning

confidence: 99%

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Irizar

Stevelink

Pernet

et al. 2021

European Journal of Psychotraumatology

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Background : British Armed Forces’ and Police Forces’ personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use. Objective : We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees. Methods : Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007–2015) ( N = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007–2009, phase 3: 2014–2016) ( N = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample). Results : Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. Conclusions : It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.

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Section: Discussionmentioning

confidence: 99%

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Irizar

Stevelink

Pernet

et al. 2021

European Journal of Psychotraumatology

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“…These findings are consistent with those of other studies suggesting that individuals with depression, anxiety disorder, and bulimia nervosa are at increased risk of drinking at unhealthy levels (Martins and Gorelick, 2011; Udo and Grilo, 2019). These subgroups may need support in limiting their alcohol consumption in order to prevent triggering or exacerbating mood and anxiety symptoms (Bahorik et al, 2016) and perceived stress (Strid et al, 2018), or developing more serious problems such as an AUD (Ordóñez et al, 2016) or chronic medical comorbidities that could complicate overall prognoses and healthcare expenses (i.e., complex needs patients) (Jolles et al, 2015). Thus, health systems and clinicians may wish to focus on these key patient subgroups when tailoring appropriate interventions.…”

Section: Discussionmentioning

confidence: 99%

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

Palzes

Parthasarathy

Felicia

et al. 2020

Alcoholism Clin & Exp Res

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Background: Unhealthy alcohol use frequently co-occurs with psychiatric disorders; however, little is known about the relationship between psychiatric disorders and alcohol consumption levels. Understanding varying levels of unhealthy alcohol use among individuals with a variety of psychiatric disorders in primary care would provide valuable insight for tailoring interventions. Methods: We conducted a cross-sectional study of 2,720,231 adult primary care patients screened for unhealthy alcohol use between 2014 and 2017 at Kaiser Permanente Northern California, using electronic health record data. Alcohol consumption level was classified as no reported use, low-risk use, and unhealthy use, per National Institute on Alcohol Abuse and Alcoholism guidelines. Unhealthy use was further differentiated into mutually exclusive groups: exceeding only daily limits, exceeding only weekly limits, or exceeding both daily and weekly limits. Multivariable multinomial logistic regression models were fit to examine associations between 8 past-year psychiatric disorders (depression, bipolar disorder, anxiety disorder, obsessive-compulsive disorder, schizophrenia, schizoaffective disorder, anorexia nervosa, and bulimia nervosa) and alcohol consumption levels, adjusting for sociodemographic and health characteristics. Results: In the full sample [53% female, 48% White, mean (SD) age = 46 (18) years], patients with psychiatric disorders (except eating disorders), compared to those without, had lower odds of reporting low-risk and unhealthy alcohol use relative to no use. Among patients who reported any alcohol use (n = 861,427), patients with depression and anxiety disorder, compared to those without, had higher odds of exceeding only weekly limits and both limits; patients with bulimia nervosa were also more likely to exceed both limits. Conclusions: Findings suggest that patients with anxiety disorder, depression, and bulimia nervosa who drink alcohol are more likely to exceed recommended limits, increasing risk of developing more serious problems. Health systems and clinicians may wish to consider implementing more robust screening, assessment, and intervention approaches to support these vulnerable subgroups in limiting their drinking.

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“…The results showed that there were treatment effects on depression for both hazardous and non-hazardous drinkers. Earlier results, on the contrary, have shown that participants with hazardous drinking at baseline were more stressed during and after treatment, and it seems that they had less treatment effect on stress compared with non-hazardous drinkers 18…”

Section: Discussionmentioning

confidence: 74%

“…In sum, patients with mental health problems should, as part of routine care, be asked about their alcohol use. Furthermore, those who report hazardous drinking should receive short interventions to help reduce their drinking, since hazardous alcohol use can negatively influence treatment effects on anxiety, symptom of anxiety and depression and stress 13 14 18. Treatments focusing on mental health problems alone appear to have little effect on hazardous drinking.…”

Section: Discussionmentioning

confidence: 99%

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Changes in alcohol consumption after treatment for depression: a secondary analysis of the Swedish randomised controlled study REGASSA

et al. 2019

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ObjectivesMental health problems and hazardous alcohol consumption often co-exist. Hazardous drinking could have a negative impact on different aspects of health and also negatively influence the effect of mental health treatment. The aims of this study were to examine if alcohol consumption patterns changed after treatment for depression and if the changes differed by treatment arm and patient sex.MethodsThis study of 540 participants was conducted in a large randomised controlled trial (RCT) that aimed to compare the effect of internet-based cognitive behavioural therapy, physical exercise and treatment as usual on 945 participants with mild-to-moderate depression. Treatment lasted for 12 weeks; alcohol consumption (Alcohol Use Disorder Identification Test (AUDIT)) and depression (Montgomery Åsberg Depression Rating Scale (MADRS)) were assessed at baseline and 12-month follow-up. Changes in alcohol consumption were examined in relation to depression severity, treatment arm and patient sex.ResultsThe AUDIT distribution for the entire group remained unchanged after treatment for depression. Hazardous drinkers exhibit decreases in AUDIT scores, although they remained hazardous drinkers according to the cut-off scores. Hazardous drinkers experienced similar improvements in symptoms of depression compared with non-hazardous drinkers, and there was no significant relation between changes in AUDIT score and changes in depression. No differences between treatment arm and patient sex were found.ConclusionThe alcohol consumption did not change, despite treatment effects on depression. Patients with depression should be screened for hazardous drinking habits and offered evidence-based treatment for hazardous alcohol use where this is indicated.Trial registration numberDRKS00008745.

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The influence of hazardous drinking on psychological functioning, stress and sleep during and after treatment in patients with mental health problems: a secondary analysis of a randomised controlled intervention study

Cited by 16 publications

References 35 publications

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

Changes in alcohol consumption after treatment for depression: a secondary analysis of the Swedish randomised controlled study REGASSA

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