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FrancoAngeli Journals

Newsletter "Clinica dell'Alcolismo"

No. 52 (2018)

People with alcohol-dependence treated in Tuscany Region (Central Italy) and in Friuli Venezia Giulia Region (Northern Italy): an epidemiological study

Submitted
agosto 23, 2019
Published
2019-09-06

Abstract

Aim: The study aimed to increase knowledge about alcohol consumption, somatic and mental co-morbidities, social problems, and use of health care services among people treated for alcohol-dependence (AD) and alcohol abuse in Tuscany and Friuli Venezia Giulia (FVG), and to compare how these two regions differ on the above mentioned variables.
Design and method: Cross-sectional study, with data collected via face-to-face interviews with a structured questionnaire. Outcome analyses were based on chi-square tests and logistic regressions.
Participants: A sample of alcohol addiction patients treated in Tuscany (N = 147) and in FVG (N = 129) were interviewed between July 2013 and February 2014.
Main results: Patients with alcohol dependence and alcohol abuse have a lower socioeconomic status in Tuscany (47.9%) than in FVG (35.7%; OR = 1.75, 95% confidence interval (CI): 1,06-2,86). Reported liver problems, anxiety and depression were significantly higher in Tuscany compared to FVG (respectively 35.4% vs. 22.5%, OR = 1.89, 95%CI 1,10- 3,22); 58,6% vs 35,7, (OR=2,56, 95%CI 2,56- 4,16); 58,9% vs 37,2% (OR=2,42, 95%CI 1,49-3,93). With regard to each of the 11 DSM-IV criteria of alcohol dependence and abuse, the probability that they occurred was 1.9 to 12 times significantly less in Tuscany than in FVG. The probability of access to Emergency Department (DEA) was lower in Tuscany than in FVG (33.3% vs 15.8%, OR=0,37, 95%CI 0,21-0,67), while contacts with general practitioners were more frequent in Tuscany than in FVG (51.7% vs. 38.8%, OR = 1.69, 95%CI 1,05-2,73).
Conclusion: The study shows that among patients with DSM-IV AD and alcohol abuse, perceived health problems and lower socio-economic conditions are greater Tuscany than in FVG; such differences could be attributed to the diverse attentions that the two regions have towards these comorbidities.
Furthermore, FVG had a greater severity of alcohol dependence and abuse than in Tuscany, with a higher consumption of hospital services, particularly of DEA, which could parallel the different drinking cultures in the two regions.

References

  1. Agenzia Regionale di Sanità Toscana (2018). Elaborazioni ARS sui dati della Regione Toscana.
  2. Alexander B. (2008). The Globalisation of Addiction: A Study in Poverty of the Spirit. Oxford: Oxford University Press.
  3. Allamani A., Centurioni A., Innocenti S., Mustur A., Fidanzini G., Puliti M. (2015). Opinione dei medici di medicina generale sul bere degli assistiti e formazione alcologica in Toscana. Toscana Medica, XXXIII(7): 40-41.
  4. Allamani A., Bravi S., Pepe P., Voller F., Marcatto F., Ferrante D., Manthey J., Rehm J., Struzzo P. (2017). Bere problematico e problemi di salute in Toscana e in Friuli Venezia Giulia: uno studio epidemiologico attraverso i medici di medicina generale. Epidemiologia e Prevenzione, 41(1): 29-37. doi: 10.19191/EP17.1.P029.009.
  5. Alonso J., Angermeyer M.C., Bernert S., Bruffaerts R., Brugha T.S., Bryson H., de Girolamo G., Graaf R., Demyttenaere K., Gasquet I., Haro J.M., Katz S.J., Kessler R.C., Kovess V., Lépine J.P., Ormel J., Polidori G., Russo L.J., Vilagut G., Almansa J., Arbabzadeh-Bouchez S., Autonell J., Bernal M., Buist-Bouwman MA., Codony M., Domingo-Salvany A., Ferrer M., Joo S.S., Martínez-Alonso M., Matschinger H., Mazzi F., Morgan Z., Morosini P., Palacín C., Romera B., Taub N., Vollebergh W.A. et al. ESEMeD/MHEDEA Investigators (2004). Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinava, 109:47-54.
  6. American Psychiatric Association (1996). Trad. it. Manuale diagnostico e statistico dei disturbi mentali, DSM IV. Quarta Edizione. Milano: Masson Italia.
  7. American Psychiatric Association (2014). Trad. it. Manuale diagnostico e statistico dei disturbi mentali, DSM-5. Quinta Edizione. Milano: Raffaello Cortina.
  8. AMPHORA-3 (2013). Report of an analysis of European alcoholrelated cultural, social and policy interactions and their impact on alcohol consumption and alcohol-related harm http://amphoraproject.net/w2box/data/Deliverables/AMPHORA_WP3_D3.2.pdf.
  9. Angus C., Latimer N., Preston L., Li J., Purshouse R. (2014). What are the implications for policy makers? A systematic review of the cost-effectiveness of screening and brief interventions for alcohol misuse in primary care. Frontiers in Psychiatry, 5(114): 1-10.
  10. doi: 10.3389/fpsyt.2014.00114.
  11. Bardazzi G., Zanna I., Ceroti M., Bendinelli B., Iozzi A., Caini S., Nesi G., Saieva C. (2017). A 5-Year Follow-Up of a Cohort of Italian Alcoholics: Hospital Admissions and overall survival. Alcoholism: Clinical and Experimental Research, 41(7): 1309-1318.
  12. Baros A.M., Wright T.M., Latham P.K., Miller P.M., Anton R.F. (2008). Alcohol consumption, %CDT, GGT and blood pressure change during alcohol treatment. Alcohol & Alcoholism, 43: 192-7. doi: 10.1093/alcalc/agm156.
  13. Basra S., Anand B.S. (2011). Definition, epidemiology and magnitude of alcoholic hepatitis. World Journal of Hepatology, 3(5): 108-113. doi: 10.4254/wjh.v3.i5.108.
  14. Brady K.T., Back S.E., Greenfield S.F. (2009). Women and Addiction: A Comprehensive Handbook. New York: Guilford Press.
  15. Bruha R., Dvorak K., Petrtyl J. (2012). Alcoholic liver disease. World Journal of Hepatology, 4(3): 81-90. doi: 10.4254/wjh.v4.i3.81.
  16. Cibin M., Mazzi M., Rampazzo L., Serpelloni G. (a cura di) (2001). L’alcologia nell’ambulatorio del medico di medicina generale, http://Studylibit.Com/Doc/6628435/L-Alcologia-Nell-Ambulatorio-Del-Medico-Di-Medicina-Generale.
  17. Cipriani G., Farchi G., Quartini A. (2000). Epidemiologia alcologica: le conseguenze dei consumi di alcol sulla salute. In: Allamani A., Orlandini D., Bardazzi G., Quartini A., Morettini A. (2000). Il Libro Italiano di Alcologia, vol. I, pp. 89-100.
  18. Cloniger C.R., Dinwiddie S.H. & Reich T. (1989). Epidemiology and genetics of alcoholism. In: Tasman A., Hales R.E., Frances A.J. (eds.). American Psychiatry Press Review of Psychiatry, 8: 293-308.
  19. Colusso L. (2004). Club degli Alcolisti in Trattamento: percorso storico. In: Allamani A., Orlandini D., Bardazzi G., Quartini A., Morettini A. (2004). Il Libro Italiano di Alcologia, vol II, pp. 289-295.
  20. Davidson K.M. (1995). Diagnosis of depression in alcohol dependence: changes in prevalence with drinking status. British Journal of Psychiatry, 166: 199-204.
  21. de Girolamo G., Polidori G., Morosini P. et al. (2006). Prevalence of common mental disorders in Italy: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Social Psychiatry and Psychiatric Epidemiology, 41(11): 853-61.
  22. Drummond C., Gual A., Goos C., Godfrey C., Deluca P., Von Der Goltz C., Gmel G., Scafato E., Wolstenholme A., Mann K., Coulton S., Kaner E. (2011). Identifying the gap between need and intervention for alcohol use disorders in Europe. Addiction, 106(Suppl 1): 31-36.
  23. Edwards G., Marshall E., Cook C. (2003). The Treatment of Drinking Problems: a Guide for the Helping Professions. Cambridge: Cambridge University Press.
  24. Erickson C.K. (2007). The Science of Addiction: From Neurobiology to Treatment. New York: W.W. Norton.
  25. Faravelli C., Abrardi L., Bartolozzi D., Cecchi C., Cosci F., D’Adamo D., Lo Iacono B., Ravaldi C., Scarpato M.A., Truglia E., Rosi S. (2004). The Sesto Fiorentino study: background, methods and preliminary results. Lifetime prevalence of psychiatric disorders in an Italian community sample using clinical interviewers. Psychotherapy & Psychosomatics, 73(4): 216-25.
  26. Fazel S., Bains P., Doll H. (2006). Substance abuse and dependence in prisoners: a systematic review. Addiction, 101: 181-91.
  27. Fazel S., Khosla V., Doll H., Geddes J. (2008). The prevalence of mental disorders among the homeless in Western Countries: systematic review and meta-regression analysis. PLoS Medicine, 5: e225. doi: 10.1371/journal.pmed.0050225.
  28. Grant B.F., Hasin D.S., Chou S.P., Stinson F.S., Dawson D.A. (2004). Nicotine dependence and psychiatric disorders in the United States, results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry,
  29. : 1108-1115.
  30. Grant B.F., Stinson F.S., Dawson D.A., Chou P., Dufour M.C., Compton W., Pickering R.P., & Kaplan K. (2004). Prevalence and Co-Occurrence of Substance Use Disorders and Independent Mood and Anxiety Disorders. Results From the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61: 807-816.
  31. Green C.A. (2006). Gender and Use of Substance Abuse Treatment Service. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism, 29(1): 55-62.
  32. Hall K., Staiger P.K., Simpson A., Best D., Lubman D.I. (2016). After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing?. Addiction, 111: 1144-1150. doi: 10.1111/add.13014.
  33. Heather N. (2018). Rethinking addiction. The Psychologist, 31(1): 24-28.
  34. Hughes J.R. (1995). Clinical implications of the association between smoking and alcoholism. In: Fertig J.B., Allen J.P. (eds.). Alcohol and Tobacco: From Basic Science to Clinical Practice. NIAAA Research Monograph 30. Bethesda, MD: National Institute on
  35. Alcohol Abuse and Alcoholism, pp. 171-185.
  36. Husain K., Ansari R.A., Ferder L. (2014). Alcohol-induced hypertension: Mechanism and prevention. World Journal of Cardiology, 6(5): 245-252. doi: 10.4330/wjc.v6.i5.245.
  37. ISTAT, Istituto Nazionale di Statistica (2015). Le cure e il ricorso ai servizi sanitari. Periodo di riferimento. Anni 2012-2013. Disponibile all’indirizzo: www.istat.it/it/archivio/156420.
  38. Karriker-Jaffe K.J., Roberts S.C., Bond J. (2013). Income inequality, alcohol use, and alcohol-related problems. American Journal of Public Health, 103(4): 649-656.
  39. Kessler R.C., Andrews G., Colpe L.J., Hiripi E., Mroczek D.K., Normand S.L., Walters E.E., Zaslavsky A.M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32: 959-76.
  40. Klingemann H., Sobell M.B., Sobell L.C. (2009). Continuities and changes in self-change research. Addiction, 105(9): 1510-1518.
  41. Kuria M.W., Ndetei D.M., Obot I.S., Khasakhala L.I., Bagaka B.M., Mbugua M.N., Kamau J. (2012). The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence. International Scholarly Research Network
  42. ISRN Psychiatry: 1-6. doi: 10.5402/2012/482802.
  43. Kushner M.G., Abrams K., Thuras P., Hanson K.L., Brekke M., Sletten S. (2005). Follow-up study of anxiety disorder and alcohol dependence in comorbid alcoholism treatment patients. Alcoholism: Clinical and Experimental Research, 29: 1432-1443.
  44. Jellinek E.M. (ed.) (1960). The Disease Concept of Alcoholism. New Haven (Conn.): Millhouse Press.
  45. Marinangeli P. (2001). Italian culture and its impact on addction. In: Straussner S.L.A. (ed.). Ethnocultural factors in Substance abuse treatment. New York, N.Y: Guilford Press.
  46. Livingston M. (2014). Socioeconomic differences in alcohol-related risk-taking behaviours. Drug and Alcohol Review, 33(6): 588-595.
  47. Mauri F., Tosi M., Rampazzo L. Ferri M., Laezza M., Gianotti C.F., Rossi Prodi P. (2004). Leggi e orientamenti regionali. In: Allamani A., Orlandini D., Bardazzi G., Quartini A., Morettini A. (2004). Il Libro Italiano di Alcologia, vol. II, pp. 127-149.
  48. Ministero della salute, Direzione generale della prevenzione sanitaria (2015). Relazione del ministro della salute al parlamento sugli interventi realizzati ai sensi della legge 30.3.2001 n. 125 “legge quadro in materia di alcol e problemi alcol correlati.
  49. Ministero della salute, Direzione generale della prevenzione sanitaria (2017). Relazione del ministro della salute al parlamento sugli interventi realizzati ai sensi della legge 30.3.2001 n. 125 “legge quadro in materia di alcol e problemi alcol correlati”.
  50. Moiraghi Ruggenini A., Zotti C., Corrao G. et al. (1988). Il medico generale e l’alcoolismo. SIMG, 3: 46-54.
  51. Moss H.B., Chen M., Yi H. (2007). Subtypes of Alcohol Dependence in a Nationally Representative Sample. Drug and Alcohol Dependence, 91(2-3): 149-158.
  52. O’Shea R.S., Dasarathy S., McCullough A.J. (2010). Alcoholic liver disease: AASLD Practice Guidelines. Hepatology, 51(1): 307-28. doi: 10.1002/hep.23258.
  53. Osservatorio permanente sui giovani e l’alcool (2007). Gli italiani e l’alcool. Quinta indagine Doxa. Roma: Risa.
  54. Osservatorio sulle dipendenze della regione Friuli Venezia Giulia (2014). Rapporto 2014 Consumo, dipendenza da sostanze e comportamenti di addiction in Friuli Venezia Giulia,
  55. www.dipendenzefvg.it/dipendenze/report.
  56. Pavarin R.M., Caputo F., Zoli G., Domenicali M., Bernardi M., Gambini D. (2015). Mortality risk in a cohort of Italian alcoholic individuals treated for alcohol dependence. Drug and Alcohol Review, 186-191. doi: 10.1111/dar.12366.
  57. Probst C., Roerecke M., Behrendt S., Rehm J. (2014). Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: a systematic review and meta-analysis. International Journal of Epidemiology, 43(4): 1314-1327.
  58. Rehm J., Shield K.D., Rehm M.X., Frick U. (2013). Modelling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union. European Neuropsychopharmacology, 23: 89-97.
  59. Rehm J., Anderson P., Barry J., Dimitrov P., Elekes Z., Feijão F., Frick U., Gual A., Gmel G. Jr, Kraus L., Marmet S., Raninen J., Rehm M.X., Scafato E., Shield K.D., Trapencieris M., Gmel G. (2015a). Prevalence of and potential influencing factors for alcohol dependence in Europe. European Addiction Research, 21(1): 6-18.
  60. Rehm J., Allamani A., Elekes Z., Jakubczyk A., Manthey J., Probst C., Struzzo P., Della Vedova R., Gual A., Wojnar M. (2015b). Alcohol dependence and treatment utilization in Europe - a representative cross-sectional study in primary care. BMC Family Practice, 29, 16(1): 90. doi: 10.1186/s12875-015-0308-8.
  61. Rehm J., Allamani A., Aubin H.J., Della Vedova R., Elekes Z., Frick U., Jakubczyk A., Kostogianni N., Manthey J., Miquel L., Paille F., Pieper L., Probst C., Scafuri F., Shield K.D., Snikere S., Struzzo P., Trapencieris M., Voller F., Wittchen H.U., Gual A., Wojnar M. (2015c). People with alcohol use disorders in specialized care in eight different European countries. Alcohol and Alcoholism, 50(3): 310-318.
  62. Rehm J., Allamani A., Della Vedova R., Elekes Z., Jakubczyk A., Landsmane I., Manthey J., Moreno-España J., Pieper L., Probst C., Snikere S., Struzzo P., Voller F., Wittchen H., Gual A., Wojnar M. (2015d). General practitioners recognizing alcohol dependence: a large cross-sectional study in 6 European countries. Annals of Family Medicine, 13(1): 28-32.
  63. Roerecke M., Rehm J. (2014). Cause-specific mortality risk in alcohol use disorder treatment patients: a systematic review and metaanalysis. International Journal of Epidemiology, 43: 906-19.
  64. Samokhvalov A.V., Popova S., Room R., Ramonas M., Rehm J. (2010). Disability associated with alcohol abuse and dependence. Alcoholism Clinical & Experimental Research, 34: 1871-8.
  65. Saieva C., Bardazzi G., Masala G., Quartini A., Ceroti M., Iozzi A., Gelain E., Querci A., Allamani A., & Palli D. (2012). General and Cancer Mortality in a Large Cohort of Italian Alcoholics. Alcoholism: Clinical and Experimental Research: 342-350.
  66. Scafato E., Allamani A., Codenotti T., Marcomini F., Patussi V., Rossi A., Struzzo P., Russo R. e il Gruppo nazionale italiano PHEPA (2006). Alcol e Primary Health Care: linee guida. Salute e Territorio, 155: 85-119.
  67. Scafato E., Gandin C., Galluzzo L., Scipione R., Monica Vichi M. & Ghirini S. per il Gruppo di Lavoro CSDA (Centro Servizi Documentazione Alcol) (2017). Epidemiologia e monitoraggio alcol-correlato in Italia e nelle Regioni. Valutazione dell’Osservatorio Nazionale Alcol sull’impatto del consumo di alcol ai fini dell’implementazione delle attività del Piano Nazionale Alcol e Salute. Rapporto 2017. Roma: Istituto Superiore di Sanità; 2017. Rapporti ISTISAN 17/1.
  68. Shield K., & Rehm J. (2012). Difficulties with telephone-based surveys on alcohol in high-income countries: the Canadian example. International Journal of Methods in Psychiatric Research, 21: 17-28.
  69. Smith J. P., & Book S. W. (2010). Comorbidity of Generalized Anxiety Disorder and Alcohol Use Disorders among Individuals Seeking Outpatient Substance Abuse Treatment. Addictive Behaviors, 35(1): 42-45. doi. 10.1016/j.addbeh.2009.07.002.
  70. Sobell L. C., Cunningham J. A., & Sobell M. B. (1996). Recovery from alcohol problems with and without treatment: prevalence in two population surveys. American Journal of Public Health, 86(7): 966-972.
  71. Üstün T.B., Kostanjsek N., Chatterji S., & Rehm J. (2010). Measuring Health and Disability. Manual for WHO Disability Assessment Schedule WHODAS 2.0. Geneva, Switzerland: World Health Organization.
  72. Volkow N. D., Koob G. F. & McLellan A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4): 363-371.

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