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The purpose of this article was to describe patterns of poor mental health/depression (PMHD) in a national sample of college students and the relationships among PMHD, alcohol consumption, harm, and abuse. Responses to mailed questionnaires completed by a random sample of 27,409 students at 119 colleges were analyzed using logistic regression. Nationally, 4.8% of students reported PMHD. The average college prevalence was 5.01% (range, 0.68% to 13.23%). Students with PMHD were more likely than their peers to be female, nonwhite, and from low socioeconomic status families; less likely to report never drinking; as likely to report frequent, heavy, and heavy episodic drinking; and more likely to report drinking to get drunk. Students with PMHD-especially females-were more likely to report drinking-related harms and alcohol abuse. College is a critical context for studying youth mental health. The interrelationship of mental health problems and their clustering by group and college are important considerations for prevention and treatment.
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PMID:Poor mental health, depression, and associations with alcohol consumption, harm, and abuse in a national sample of young adults in college. 1506 Apr

This paper reports results of an analysis of the association between alcohol intoxication and injection and sexual HIV risk behaviors among 557 Hispanic heroin and cocaine injectors, not in treatment, who were recruited in poor communities in Puerto Rico. Subjects were part of a longitudinal prevention-intervention study aimed at reducing drug use and HIV risk behaviors. Participants reported a high prevalence of co-occurring conditions, particularly symptoms of severe depression (52%) and severe anxiety (37%), measured by Beck's Depression Index and Beck's Anxiety Index, respectively. Alcohol intoxication during the last 30 days was reported by 18% of participants. Associations were found between alcohol intoxication and both injection and sexual risk behaviors. In the bivariate analysis, subjects reporting alcohol intoxication were more likely to inject three or more times per day, pool money to buy drugs, share needles, and share cotton. They were also significantly more likely to have a casual or paying sex partner and to have unprotected sex with these partners. After adjustment, sharing needles and cotton, having sex with a paying partner or casual partner, and exchanging sex for money or drugs were significantly related to alcohol intoxication. HIV prevention programs, to be effective, must address alcohol intoxication and its relation to injection and sexual risk behaviors as a central issue in HIV prevention among drug injectors.
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PMID:HIV risk behaviors and alcohol intoxication among injection drug users in Puerto Rico. 1556 74

A number of studies have established a strong connection between acute inebriation, alcohol addiction and suicides, as the last act of alcoholism or an act of desperation in an alcoholic's family, an act of escape from restraints in state of depression or as a way of self-destruction. In recent years in average 600 people per year committed suicide. Slovenia is a country with extremely high and variable suicide tendencies and harmful alcohol use levels, as well as a high level of alcohol-related troubles. The aim of our research was to ascertain some typical features, especially those connected to the inebriation of suicide victims from a wider Ljubljana region. Autopsies were carried out on the victims in the period between 1995 and 1999. There were 508 (31.2%) suicides among all the analyzed violent deaths; 73.2% of them were men. The average age of the victims was 46.5 years. Most suicides were committed at home (50.0%). 25.4% were completely sober in the moment of the act, while in all other cases inebriation was established, the average value being 9.57 g/kg. Men were drunk in 87.1% of cases, women only in 12.9% and the given alcohol levels were substantially higher with men (0.65:0.26 g/kg). The share of inebriated persons decreases with age-reaching its peak in the 35-54 age group. Regarding the method, the predominant ones are intoxication and the use of firearms, which is a typical way of committing suicide among men, while women rather choose jumping from great heights and drowning. Alcohol was present in as many as 55.7% of suicides with intoxication and in 68.8% of all suicides committed by using firearms, while the highest alcohol levels were found in those who died from cutting their veins (2.01 g/kg). Based on this and on other research, more effort should be focused on alcohol abuse prevention, making all people aware of the consequences of alcohol abuse, the possibilities of treatment and their availability as well as possible co-morbid depressions. Simultaneously, due to an established link, the national alcohol policy and strategy for prevention of suicides should be professionally harmonized.
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PMID:Presence of alcohol in suicide victims. 1569 38

We studied the association between two major problems--unemployment and major depressive episode--and the impact of different timing of periods of unemployment and risk factors, especially alcohol intoxication, for major depressive episode among the unemployed. Major depressive episode during the last 12 months, plus current and past employment status and frequency of alcohol intoxication, were assessed within the nationally representative, cross-sectional 1996 Finnish Health Care Survey, in which non-institutionalized individuals aged 15-75 years were interviewed by using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). Of the 5993 subjects interviewed, 3818 (64%) were occupationally active and included in the logistic regression analysis, showing that even after adjusting for other potentially confounding variables, current unemployment was associated with major depressive episode (odds ratio, OR=1.78, 95% confidence interval, CI, 1.38-2.29). Further analysis revealed that the increased risk of major depressive episode was only related to long-term unemployment. Frequent alcohol intoxication (at least once a week) increased the risk of major depressive episode remarkably. Compared with the group "Constantly employed, no frequent alcohol intoxication", long-term unemployment with no frequent alcohol intoxication had moderately increased risk of major depressive episode (OR=1.72 (95% CI 1.29-2.30) and those with frequent alcohol intoxication had highly increased risk [OR=11.27 (95% CI 5.51-23.09) vs. OR=1.72 (95% CI 1.29-2.30]. Long-term unemployment is associated with increased risk of major depressive episode. Frequent alcohol intoxication among long-term unemployed individuals greatly increases the risk of depression.
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PMID:Major depressive episode related to long unemployment and frequent alcohol intoxication. 1631 2

The concept of "structural plasticity" has emerged as a potential mechanism in neurodegenerative and psychiatric diseases such as drug abuse, depression, and dementia. Chronic alcoholism is a progressive neurodegenerative disease while the person continues to abuse alcohol, though clinical and imaging studies show that some recovery may occur with abstinence. The neural plasticity observed in chronic alcoholism coupled with conflicting reports on alcohol-induced hippocampal neuropathology make this disease ripe for reconsideration in terms of the phenomenon of adult neurogenesis. This review describes opposing neurogenic processes that occur with alcohol intoxication and abstinence following alcohol dependence and how these opposing events relate to neurodegeneration and recovery from chronic alcoholism.
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PMID:Alcohol and adult neurogenesis: roles in neurodegeneration and recovery in chronic alcoholism. 1642 63

In 2003 were promulgated the texts regulating rest and safety, in the USA (approved by the ACGME) and in France (January 9th, 2001 and September 14th, 2001). The institution of the "rest for safety", an eleven hours duration interruption of activity, immediately after a night-call, can be viewed as a progress in the search for safety. Several studies showed a link between excessive work hours and occurrence of medical incidents related to tiredness. However published data do not show a link between tiredness and patients endangering. The tiredness resulting from sleep deprivation and disturbances in circadian rhythms is a cumulative phenomenon erased by a period of rest. In spite of a large individual variability, tiredness increases anxiety scores, irritability, depression and it deteriorates cognitive performances. The concept of "prophylactic" rest considers that a subject cannot start, rested, a work if he did not sleep at least 5 hours the previous night, or 12 hours during the previous 48 hours. The second important aspect of the rest for safety is the long-term prevention of potential pathologies in medical staff, in particular burnout syndrome. In our profession, night calls are considered most stressful; the psychological stress related to anticipation and night context causes measurable cardiovascular disturbances in anesthesiologists. Shift-work sleep disorders may induce gastric ulcers, heart attacks, metabolic syndrome, depression and accidents related to somnolence. Long duration work-hours, accompanied by sleep deprivation, may double the risk of car accidents in junior physicians, in whom vigilance levels can compare with those of patients concerned by narcolepsy or with the cognitive disturbances induced by alcohol intoxication. Reduced work-hours improve vigilance and divide by three the rate of serious medical errors. True opportunities of sleep and control of sleep duration at the individual level could be suggested. The idea that taking the necessary rest would be synonymous with a decrease of efficiency in patient care is not demonstrated, but the danger of a poorer information transmission should be handed with an optimization of our manpower and organization. Aging is accompanied by a progressive disorganization of sleep. The foreseeable shortage of manpower, synonymous with aging of the medical actors and increased vulnerability to tiredness, is a posteriori the justification of the institution of the rest for safety.
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PMID:[Rest for safety: which stakes?]. 1748 45

For social, cultural and historical motives alcohol (ethanol or isopenthanol) is considered to be just a beverage rather than a liquor. However, from a pharmatherapeutic point of view alcohol is a depressor of the central nervous system. The effects of alcohol consumption can range from raised loquacity to drunkenness, loss of consciousness and death as a result of insufficient respiration. Probably the most frequent pharmacological interaction is the combination of alcohol with other depressors of the central nervous system which increases the depression even further. Some medicaments which more frequently produce an interaction are antihistamines, analgesics, antidepressants and medicaments for coughs, common cold and influenza. Paracetamol or acetaminophen is an analgesic medicament similar to acetylsalicylic acid lacking anticoagulatory properties and gastric irritation. However, its major drawback is hepatic toxicity as a result of a toxic metabolite produced in the liver by cytochrome P-450, principally cytochrome CYP2E1, which is detoxified under normal conditions by hepatic glutathione. Ethanol is also detoxified by CYP2E1, which is an inducer of ethanol such that chronic ingestion increases the level of this enzyme. When the ingestion of alcohol is stopped, CYP2E1 is greatly increased and only metabolises the paracetamol giving rise to high quantities of hepatotoxic metabolites so that the hepatic glutathione is unable to detoxify resulting in irreversible hepatic damage. Therefore for odontologists it is important that in chronic alcoholic patients the consumption of alcohol should not be suspended on prescribing paracetamol.
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PMID:Interaction of paracetamol in chronic alcoholic patients. Importance for odontologists. 1837 47

Finnish middle adolescents (n=3242) were assessed for family characters, family life events, depression and frequent drunkenness. Odds ratios for maladjustment outcomes associated with each event were computed and logistic regression models were used to estimate the effect of confounders. In the presence of serious illness or injury of a family member, increasing conflicts between parents and financial difficulties in the family, the probability of depression was twice as high than without the presence of these events. Parental unemployment, parent getting involved with the law and financial difficulties in the family were associated with frequent drunkenness. The associations between life events and depression were fairly similar among boys and girls. Among girls there were several events associated with frequent drunkenness even when family structure and socio-economic status were accounted for, while among boys there were only few. The significance of associations between family life events and depression may vary between the specific events while the associations between family life events and frequent drunkenness may be better explained with cumulative stress. Both males and females react to family stress, but the symptoms presented may differ. In case of family adversities, both internalizing and externalizing outcomes must be screened for.
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PMID:Significance of family life events in middle adolescence: a survey on Finnish community adolescents. 1901 55

The impact of alcohol use on the course of adolescent depression over one-year was investigated by following 197 consecutive adolescent outpatients with unipolar depression in a naturalistic treatment setting. Their baseline alcohol consumption was categorized in three groups: excessive use (defined as weekly drunkenness), regular use (monthly use, not weekly drunkenness), and no/occasional use (abstinence/less than monthly use). During the monthly BDI follow-up, the excessive users achieved remission less frequently, and after one year, had poorer psychosocial functioning than the no/occasional users. In conclusion, excessive alcohol use negatively affects the course of adolescent depression and psychosocial functioning. Weekly drunkenness seems to be of predictive value and this can be examined with a few simple questions. Means of reducing alcohol consumption among depressed adolescents are worth further investigations.
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PMID:Brief Report: Excessive alcohol use negatively affects the course of adolescent depression: one year naturalistic follow-up study. 1969 93

Rape is a well-established risk factor for mental health disorders such as posttraumatic stress disorder (PTSD) and depression. However, most studies have focused on forcible rape tactics and have not distinguished these from tactics that involve drug or alcohol intoxication. The authors' aim was to examine correlates of PTSD and depression in a community sample of women, with particular emphasis on evaluating the unique effects of lifetime exposure to three specific rape tactics. A nationally representative sample of 3,001 noninstitutionalized, civilian, English- or Spanish-speaking women (aged 18-86 years) participated in a structured telephone interview by use of Computer-Assisted Telephone Interviewing (CATI) technology. Multivariable models showed that history of drug or alcohol-facilitated rape tactics (OR = 1.87, p < .05) and history of forcible rape tactics (OR = 3.46, p < .001) were associated with PTSD. History of forcible rape was associated with depression (OR = 3.65, p < .001). Forcible rape tactics were associated with a number of factors that may have contributed to their stronger association with mental health outcomes, including force, injury, lower income, revictimization history, and labeling the event as rape. The results underscore the importance of using a behaviorally specific assessment of rape history, as rape tactic and multiple rape history differentially predicted psychopathology outcomes. The association between drug- or alcohol-facilitated rape tactics and PTSD suggests that these are important rape tactics to include in assessments and future studies.
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PMID:Drug- or alcohol-facilitated, incapacitated, and forcible rape in relationship to mental health among a national sample of women. 2010 Aug 96


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