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Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

At the present time there is a general dissatisfaction among both theoreticians and practitioners with the disease model of alcoholism. It is often felt that it has served its usefulness. This can be witnessed in the literature in the increased questioning of the central components of the alcohol addiction model. Such dissatisfaction is not new but the present unease has resulted in the creation of new models of problem drinking. New theories of alcoholism have been expressly fashioned to replace outmoded ideas.

The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS).

A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS).

Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies.

Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies.

The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.

The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department.

A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population.

The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively.

The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score.

The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life.

The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.

Alcohol‐related brain damage (ARBD) is an increasing challenge for service providers working with older people and adults. It has a complex aetiology and does not progress in the same way as other causes of dementia. The devastating effects of ARBD undermine a person's ability to lead an independent life, yet it is thought that with the right interventions, a degree of recovery can be seen in 75% of sufferers. People with ARBD do not neatly fit into an existing category of care; they ‘fall through the net’ at multiple points in the care pathway. Using a patient synopsis drawn from clinical practice the author illustrates the impact of an advanced practice role in relation to the nursing care of patients with ARBD, as well as making suggestions for the provision of education and support for mainstream services.

This paper offers readers a review of the literature on alcohol and illicit drug misuse in people with learning disabilities, focusing on six key areas. First, clarity is provided on the definition of ‘misuse’. Second, prevalence rates are examined along with the methodological difficulties involved in such studies, the authors arguing that prevalence rates are higher than current estimates. Third, the authors explore the relationship between the intra‐ and inter‐personal risk factors. Fourth, the nature of the substance misuse is explored, with a focus on offending behaviour. Fifth, a range of treatment modalities are described with a series of recommendations for more robust evidence‐based interventions. Last, the authors explore the gaps in policy that lead to a dearth in service provision as well the barriers which people with learning disabilities face on entering treatment services. The paper cites four innovative projects that address this population's needs in England, and illustrates how Northern Ireland has positioned the needs of this hidden population within the Department of Health, Social Services and Public Safety (Northern Ireland).

Problem drinking includes a spectrum of drinking habits ranging from excessive alcohol intake to alcohol dependence. Numerous risk factors are thought to increase the susceptibility to such drinking patterns ‐ genetic, environmental and constitutional. Although alcohol misusers are frequently stereotyped, from interviewing numerous patients it is evident that there is no ‘typical alcoholic’. Alcohol consumption screening is widely used; however, it is important for healthcare professionals to understand the social and psychological aspects of problem drinking before advising abstinence. With this understanding, it is clear that governmental legislation with regards to alcohol is more likely to cut down the number of social binge drinkers than the number dependent on alcohol. The onus of reducing the number of individuals developing diseases as a result of chronic alcohol misuse, therefore, lies with the healthcare profession; early screening of alcohol consumption and early psychological intervention for susceptible individuals is key in this prevention.

To study the situation of alcohol relapse and to investigate the relationship between psychological factors and alcohol relapse in persons with alcohol dependence in Thai Nguyen hospitals, Vietnam.

A correlation study was conducted among 110 patients. Data were collected through structured interviews and were analyzed using descriptive statistics and Spearman's correlation coefficient (r_s).

More than two-thirds of the participants were found to relapse more than once (X¯ = 2.04, SD = 0.86). Positive outcome expectancies, cravings, negative emotional states, and maladaptive coping were positively associated with relapse (r_s = 0.550, 0.522, 0.497; p = 0.000 and r_s = 0.217, p < 0.05, respectively). While, motivation to change with three subscales had a negative correlation to relapse including recognition (r_s = −0.199, p < 0.05), ambivalence (r_s = −0.331, p = 0.000), and taking steps (r_s = −0.606, p = 0.000). Adaptive coping, self-efficacy, and social support were also found to be negatively correlated to relapse (r_s = −0.535, −0.499, −0.338; p = 0.000, respectively). However, negative outcome expectancies (r_s = −0.024, p = 0.805) and positive emotional states (r_s = 0.081, p = 0.399) were not significantly related to relapse.

The findings of this study are significant implications for relapse prevention strategies. It suggests that the essential parts of relapse prevention are through: changing alcohol expectations, increase drinking refusal self-efficacy, coping skills training, enhancing motivation to change, managing alcohol craving and expanding social support.

This is the first study in Vietnam which investigated the relationship between psychological factors and alcohol relapse in individuals with alcohol dependence.

The aim was to study how the working-age population's mental symptoms had a relation to the using of the Internet. In addition, the aim was to analyze how the mental symptoms had a relation to background information. The study was carried out as a cross-sectional study by posting a questionnaire to 15,000 working-age (18-65) Finns. Mental symptoms of responses (6121) were analysed using the model factors age, gender and use of the Internet. Only 0.06% mentioned that they were somehow addicted to the Internet. Based on statistical analyses, age and marital status had an influence on many mental symptoms. The use of the Internet at leisure had an influence on substance addiction and fear situations. The importance of the Internet only had an influence on the fear situations. In the future it will be essential to take into account that the use of the internet can affect mental symptoms.

The purpose of this paper is to examine the prevalence of alcohol use disorders (AUDs) amongst young people in the criminal justice system (CJS) in the North East of England and to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) to the Youth Justice Board ASSET tool in identifying alcohol-related need in Youth Offending Team (YOT) clients.

A validated screening tool (AUDIT) was used to identify alcohol-related health risk or harm. Findings from AUDIT were compared with those of the standard criminogenic risk screening tool used in CJS (ASSET). An anonymous cross-sectional questionnaire was administered during a one-month period in 2008. The questionnaires were completed by 11-17-year-old offenders who were in contact with three YOTs, one Youth Offending Institution and one Secure Training Estate.

In total, 429 questionnaires were completed out of a possible 639 (67 per cent). The majority (81 per cent) of the young offenders were identified as experiencing alcohol-related health risk or harm and 77 per cent scored within a possibly alcohol-dependent range. In total, 77 (30 per cent) of young people completing both assessments were identified as having an AUD by AUDIT but not identified as needing alcohol-related treatment using ASSET.

This research was confined to one geographical area of England, however, the results show that even in this area of high drinking by young people the levels of AUDs amongst young people in the CJS are very high.

There are major social implications to this research. It is imperative for changes to be made to the care pathways in place in the UK for young people coming through the CJS with alcohol-related issues.

This paper adds to the evidence base by using well-validated tools to measure alcohol use amongst young people in the CJS in the UK.