Damian Czarnecki

Orexin in Patients with Alcohol Dependence Treated for Relapse Prevention: A Pilot Study

AIM The aim of the study was to assess the blood concentration of orexin and its association with other clinical factors in patients with alcohol dependence. METHODS Thirty-two males hospitalized on an addiction treatment ward due to alcohol dependence and 23 healthy men as a control group were enrolled in the study. The measurement of orexin in the blood was made at the beginning of the treatment (after withdrawal symptoms had stopped) and again after 4 weeks of observation. RESULTS At the beginning of the observation, the alcohol-dependent patients had significantly greater orexin blood concentration than the control group. After 4 weeks of treatment for relapse prevention, the blood orexin level decreased significantly to a value similar to that in the control group. At the beginning of the study, more severely alcohol-dependent patients (Short Alcohol Dependence Data [SADD] score range: 20-45) had significantly greater orexin blood concentration than individuals with moderate addiction severity (SADD score range: 10-19). However, after 4 weeks of abstinence, the peptide blood concentration was similar in both groups of alcoholic patients. CONCLUSIONS Orexin or its receptor is a potential target for relapse prevention treatment, but further study with long-term observation is needed to verify the usefulness of blood orexin determination as a marker of alcohol relapse risk.

Oxidoreductive homeostasis in alcohol-dependent male patients and the risk of alcohol drinking relapse in a 6-month follow-up

Disturbances in the central signaling of reactive oxygen species (ROS) in response to energy intake are recognized as taking part in appetitive and consummative phases of eating disorders. This study aimed to verify the hypothesis that blood oxidoreductive balance can also affect demand for energy substances, such as alcoholic beverages in alcohol-dependent individuals, as well as the severity of their alcohol dependence and risk of drinking relapse. The following values were determined in the blood of 54 alcohol-dependent male patients after alcohol withdrawal, again after 4 weeks and after 6 months: the aldehyde products of lipid peroxidation (malonyl dialdehyde [MDA] and 4-hydroxynonenal [4-HNE]), nitric oxide (NO) metabolites, total antioxidant status (TAS), the blood activities of glutathione peroxidase (GSHpx), superoxide dismutase (SOD), glutathione reductase (GSHred), blood glucose, and lipids. Alcoholics who relapsed during 6 months of observation (n = 31, 57%) compared with patients who maintained alcohol abstinence for 6 months (n = 23, 43%) differed only in relation to initial and final NO metabolite serum concentrations. The risk of alcohol drinking relapse was lower in patients with an above-median initial blood concentration of NO metabolites and TAS. The oxidative stress parameters correlated with alcohol-dependence severity markers. No significant correlations between the studied antioxidant balance parameters and markers of nutritional status, including blood glucose and lipids, were found. Although the results of our study have some limitations and require further investigation, they suggest the role of oxidoreductive balance in the pathomechanisms of alcohol dependence and drinking relapse. In addition, due to a lack of association found between blood oxidative stress parameters and BMI, blood glucose, and lipid concentrations, they show the presence of disturbances in systemic ROS signaling in response to energy availability in alcoholics after alcohol withdrawal.

Suicidal thoughts in persons treated for alcohol dependence: The role of selected demographic and clinical factors

Greater knowledge is needed of potential predictive factors for suicide in cases of alcohol addiction. Therefore, the aim of the study was to identify the socio-demographic variables and clinical factors associated with alcohol dependence which may have an influence on the occurrence of suicidal thoughts in alcohol-dependent patients. A group of 510 patients (396 male and 114 female) diagnosed with alcohol dependence syndrome were interviewed during the third week of therapy according to the Beck Depression Inventory (BDI), the Penn Alcohol Craving Scale (PACS) and the Short Alcohol Dependence Data Questionnaire (SADD). Socio-demographic data was also collected. The results of a binary logistic regression with suicidal thoughts as a dependent variable show that 63 out of the 510 participants (12% of the sample) reported the presence of suicidal thoughts. Alcohol dependence and alcohol craving appear to increase the likelihood of suicidal thoughts, and participants presenting psychiatric disorders were twice as likely to demonstrate suicidal ideation as those who did not. Alcohol dependence, alcohol craving and psychiatric comorbidity may be regarded as risk factors for suicidal ideation in the studied sample, with the only protective factor being living in a relationship.

The life satisfaction level of obese people with depressive disorders compared to healthy individuals

Introduction. This research examines the relationship between obesity and pessimism, a decreased sense of happiness, reduced positive affect, and a low life satisfaction level. Objective. To measure the level of life satisfaction of obese people with depressive symptoms in contrast to healthy individuals from the general population, and the relationship between the selected socio-demographic variables and mood disorders, and life satisfaction. Materials and methods. The study involved 30 healthy subjects (the control group), 30 obese people hospitalised in the Department of General and Endocrine Surgery, and 30 patients with depressive disorders treated in the Department of Psychiatry. The study draws upon a interview questionnaire: the Satisfaction with Life Scale (SWLS), and the Beck Depression Inventory (BDI). Results. It was found that the level of life satisfaction of respondents from all three groups remained at an average level. The highest level of life satisfaction was achieved in the healthy group, and the lowest in those with depression. On the other hand, the level of life satisfaction of obese people did not substantially diverge from healthy subjects. Conclusions. The life satisfaction of obese people remained at a similar level to the healthy population. A twoway relationship between depression and obesity was shown among patients with depressive disorders and those with obesity. The higher the level of education, the greater the level of life satisfaction; however, this lessens with age and the intensification of depressive symptoms.

Blood glucose and lipid concentrations after overload are not associated with the risk of alcohol relapse

AIMS There is evidence for the functioning of feedback between alcohol consumption and fat (positive) and carbohydrate (negative) intake. We tried to verify the hypothesis that blood glucose and lipid concentration in a fasting state and after loading may affect the risk of relapse in alcohol-dependent male patients during withdrawal therapy. METHODS Blood glucose, total cholesterol (TC) and triglycerides (TG) were determined at the beginning of the study, and again after 4 weeks and 6 months of observation in 54 alcohol-dependent male patients treated against drinking relapse. Glucose concentration was checked after fasting and 2h after loading with a 75 g water solution of glucose, and blood lipids were determined on an empty stomach and 5h after butter loading (0.5 g of butter per kilogram of body mass). RESULTS Patients who relapsed compared to subjects who remained abstinent during the 6-month observation did not differ significantly in relation to blood glucose, TC or TG blood concentrations, either in a fasting state or after loading. Patients with an initial above-median increase in TG blood concentration after butter loading (>38%) before the beginning of the study, and who smoked cigarettes with a greater content of nicotine and tar, preferred vodka and had lower values of aminotransferases. CONCLUSION Fasting and postprandial blood glucose, TC and TG concentrations had no relationship with the outcome of anti-relapse treatment. However, they presented some associations with the pathomechanism of addiction to nicotine.

Przyjmowanie substancji psychoaktywnych i konsekwencje zdrowotne zaprzestania ich stosowania w grupie młodzieży licealnej

Introduction. The use of psychoactive substances is an important factor of higher risk of health complications and deficits in social functioning of children and adolescents. It is a problem regarding not only particular individuals or families but it also constitutes, in further perspective, a serious social-economic problem. Aim. The aim of this study was to assess the type and frequency of using psychoactive substances as well as psychics and somatic consequences after withdrawal from psychoactive substances use in high school students groups. Material and Methods. The research was carried out in the group of 100 students from a secondary school in Torun (61 female students, aged 18,2±0,4 and 39 male students aged 18,1±0,3). Our own questionnaire was applied and the questions included referred to socio-demographic variables, to the use psycho-active substances and the symptoms after withdrawal from them, as well as the CAGE scale for the purpose of assessing the risk of addiction to alcohol and marijuana (the modified version of the scale). Results. It has been observed that the psychoactive substances most frequently used in groups of students (female and male) included: alcohol drinks (88% vs. 79%), caffeine (75% vs. 61%), nicotine (almost 51% vs. 36%), marijuana (39% vs. 43%), hashish (almost 10% vs. 5%), “boosters” (8% vs. 10%), amphetamine (3% vs. 13%) and others. The suicidal inclinations were observed in 4,9% of female students. Probably 5% of female and from 5 to 7% of male students experienced the psychotic symptoms (hallucinations and delusions) after withdrawing from the use of psychoactive substances. Conclusions. The legal psychoactive substance most frequently used was ethyl alcohol (risk of addiction in groups: 37% of female and 23% male students) whereas the illegal substance was marihuana (risk of addiction was proved in groups: 18% of female and 35% of male students). The most important complications following the withdrawal from the use of psychoactive substances included suicidal behavior and psychotic symptoms (hallucinations and the feeling of being observed) correlated with amphetamine use. (JNNN 2014;3(3):100–106)

A preliminary study assessment of the nutritional status of alcohol dependent inpatients – cigarette smokers and non-smokers

Abstract Introduction The abuse of alcohol as well as smoking affects behaviour related to nutrition and nutritional state. The aim of the research was to assess the nutritional status of alcohol dependent patients, smokers and non-smokers, assigned to subgroups by age and clinical variables. Material and Method The examined group was composed of 49 alcohol-dependent males undergoing inpatient treatment aged 27–69 (17 non-smoking and 32 tobacco smokers). A number of socio-demographic and clinical interviews were carried out with the patients, and anthropometric measurements and blood samples were taken for laboratory tests. Results The anthropometric research indicated that the subjects who abused alcohol and smoked cigarettes had BMI (Body Mass Index), FM% (percentage body Fat Mass) and WHR (Waist/Hip Ratio) scores below the norm. The AMC (fat-free Arm Muscle Circumference) variable score was similar for subjects who were both smokers and non-smokers. Discussion The metabolic processes that regulate the nutrition status of alcohol dependent subjects are complex. Therefore, besides use of nicotine as a factor of body mass reduction, we could look for other variables such as age, length and intensity of alcohol dependence, quantity of alcohol doses or liver function. However, research results show that nicotine smoking especially leads to decrease of body mass. Conclusion Smoking is an important factor affecting the values of nutrition indicators among alcohol dependent persons.