Erkek Alkol Bağımlılığında Nüks ile Biyokimyasal Etmenler Arasındaki İlişki Var Mıdır?

Year 2014, Volume: 15 Issue: 3, 238 - 245, 01.12.2014

Abdullah Akpınar Mehmet Çevik Erman Bağcıoğlu

Abstract

Objective: In this study we aimed to observe the biochemical variables which probably relates to relapse in six months after discharge from inpatient unit for patients with male alcohol dependence. Material and Methods: Study sample comprise of 89 consecutive male patients who were treated at Samsun Mental Health Hospital Alcohol and Drug Research, Treatment and Training Center in 2010. After completion of the detoxification phase, patients were divided in two groups according to whether they have been relapsed or not in 6 months after discharge and the biochemical parameters which is taken in the beginning of hospitalization and sociodemographic properties of these two groups have been compared. Results: In this study findings of 89 male patients have been examined comperatively. After six months which is determinated as remission duration; there were no statistical difference between 49 relapsed and 40 non relapsed patients in terms of either biochemical parameters and sociodemographic (p>0,05). Conclusion: In this study which is conducted with male patients diagnosed with alcohol dependence; findings endorse that relapse cannot be envisaged. On the other hand, the difference between urea values which forms a statistical tendency is encouraging to draw up future studies with greater sample sizes

Keywords

Alcohol dependence; relapse; biochemical parameters

Erkek Alkol Bağımlılığında Nüks ile Biyokimyasal Etmenler Arasındaki İlişki Var Mıdır?

Abstract

Amaç: Bu çalışmanın amacı erkek alkol bağımlılığında yataklı tedavi sonrası altı ay içinde alkol kullanımının yinelenmesini (nüks) öngörme ile ilişkili olabilecek biyokimyasal etmenleri değerlendirmektir. Gereç ve Yöntem: Çalışma grubu olarak, 2010 yılında ardışık olarak Samsun Ruh Sağlığı Hastalıkları Hastanesi Alkol Madde Araştırma Tedavi Merkezi servisinde yatarak tedavi edilen 89 alkol bağımlılığı tanılı hasta belirlenmiştir. Yataklı ünitede detoksifikasyon tedavileri tamamlanan hastalar 6 ay içerisinde alkol kullanımlarının yinelenip yinelenmediği temel alınarak iki gruba ayrılmıştır ve hastaların yatışlarındaki başlangıç biyokimyasal etmenlerin düzeyleri ve sosyodemografik özellikleri ile karşılaştırılmıştır. Bulgular: Belirlenen remisyon süresi olan 6 aylık takip sonucunda tekrar alkol alımı olmayan 40 hasta ile nüks gerçekleşen 49 hasta arasında biyokimyasal parametreler ve sosyodemografik değişkenler açısından istatistiksel bir fark saptanmamıştır (p>0,05). Sonuç: Yatarak tedavi gören alkol bağımlılığı tanısı almış erkeklerde yapılan bu çalışmada nüksün mevcut biyokimyasal etmenlerle öngörülemeyeceği yönünde veriler elde edilmiştir. Buna karşın üre değerlerindeki farkın istatistiksel fark eğilimi oluşturması büyük örneklem sayılı yeni çalışmaların yapılması açısından cesaret vericidir

Keywords

Alkol bağımlılığı; nüks; biyokimyasal etmenler

References

• Çelikkol A (Editör): Alkol kullanım bozuklukları ve tedavisi. 1inci Baskı, İzmir: Ege Psikiyatri Sürekli Yayın- ları, 1996. http://www.samhsa.gov/data. Substance Abuse and Mental Health Services Administration. Results from the 2010 national survey on drug use and health: summary of national findings. NSDUH Series
• H-41, HHS Publication No. (SMA) 11-4658. Rockville,
• MD: Substance Abuse and Mental Health Services Administration; 2011.
• Cunningham JA, McCambridge J. Is alcohol de- pendence best viewed as a chronic relapsing disor- der? Addiction 2011;107(1):6-12.
• Maisto SA, Pollock NK, Cornelius JR, Lynch KG, Martin CS. Alcohol relapse as a function of relapse definition in a clinical sample of adolescents. Addic- tive Behaviors 2003;28(3):449-59.
• Marlatt GA, Gordon JR. Determinants of relapse: Implications for the maintenance of behavior change. In: Davidson, PO. Davidson SM (editors). Behavioral medicine: Changing health lifestyles. New York: Brun- ner/ Mazel, 1980:410-52.
• Marlatt GA, Gordon JR (Editors). Relapse preven- tion: Maintenance strategies in the treatment of addictive behaviors. New York: Gulliford Press; 1985.
• Tempesta E, Janiri L, Bignamini A, Chabac S, Potgieter A. Acamprosate and relapse prevention in the treatment of alcohol dependence: a placebo- controlled study. Alcohol Alcohol 2000;35(2):202-9.
• Longabaugh R, Wirtz PW, Gulliver SB, Davidson D. Extended naltrexone and broad spectrum treatment or motivational enhancement therapy. Psychophar- macology (Berl) 2009;206(3):367-76.
• Stanton M. Relapse prevention needs more em- phasis on interpersonal factors. American Psycholo- gist 2005;60(4):340-1.
• Connors GJ, Maisto SA, Donovan DM. Conceptual- izations of relapse: a summary of psychological and psychobiological models. Addiction 1996;91(suppl):5- glutamyltranspeptidase and carbohydrate-deficient transferin: alternative measures of excessive alcohol consumption. Clin Exp Res 1995;19(6):1541-6. G
• Schmidt LG, Schmidt K, Dufeu P, Ohse A, Rommelspacher H, Müller C. Superiority of carbohy- drate-deficient transferrin to g-glutamyltransferase in detecting relapse in alcoholism. Am J Psychiatry Salaspuro M. Biological state markers of alcohol abuse. Alcohol Health Res World 1994;18(2):131-9.
• Rosman AS, Lieber CS. Biochemical markers of alcohol consumption. Alcohol Health Res World 1990;14(3):208-18.
• Salaspuro M. Conventional and coming laboratory markers of alcoholism and heavy drinking. Alcohol Clin Exp Res 1986;10(supl 6):5-12.
• Cohen E, Feinn R, Arias A, Kranzler HR. Alcohol treatment utilization: Şndings from the national epi- demiologic survey on alcohol and related conditions. Drug Alcohol Depend 2007;86(2-3):214-21.
• Miller WR, Walters ST, Bennett ME. How effective is alcoholism treatment in the United States? J Stud Alcohol 2001;62(2):211-20.
• Soyka M, Hasemann S, Scharfenberg CD, Löhnert B, Bottlender M. New possibilities in treatment and rehabilitation of alcohol-dependent patients--a catamnestic study on the efficiency of outpatient treatment programmes demonstrated by a model procedure. Nervenarzt 2003;74(3):226-34.
• Timberlake DS, Hopfer CJ, Rhee SH, et al. College attendance and its effect on drinking behaviors in a longitudinal study of adolescents. Alcoholism: Clinical and Experimental Research 2007;31(6):1020-30.
• Mitchell C, Simpson D, Chick J. Carbohydrate-defi cient transferin in detecting relapsein alcohol de- pendence. Drug Alcohol Depend 1997;48(2):97-103.
• Junghanns K, Graf I, Pflüger J, et al. Urinary ethyl glucuronide (EtG) and ethyl sulphate (EtS) assess- ment: valuable tools to improve verification of ab- stention in alcohol-dependent patients during in- patient treatment and at follow-ups. Addiction 2009;104(6):921-6.
• Morini L, Marchei E, Vagnarelli F, et al. Ethyl glucuronide and ethyl sulfate in meconium and hairpotential biomarkers of intrauterine exposure to ethanol. Forensic Sci Int 2010;196(1-3):74-7.
• Morini L, Politi L, Polettini A. Ethyl glucuronide in hair. A sensitive and specific marker of chronic heavy drinking. Addiction 2009;104(6):915-20.
• Aertgeerts B, Buntinx F, Ansoms S, Fevery J. Screening properties of questionnaires and laborato- ry tests for the detection of alcohol abuse or depend- ence in a general practice population. Br J Gen Pract 2001;51(464):206-17.
• Marcos Martín M, Pastor Encinas I, Laso Guzmán F. Biological markers for alcoholism. Revista Clínica Española 2005;205(9):443-5.
• Conigrave KM, Saunders JB, WhitŞ eld JB. Diag- nostic tests for alcohol consumption. Alcohol Alcohol 1995;30(1):13-2.
• Koivisto H, Hietala J, Anttila P, et al. Long-term ethanol consumption and macrocytosis: diagnostic and pathogenic implications. J Lab Clin Med 2006;147(4):191–6.
• Cylwik B, Czygier M, Daniluk M, Chrostek L, Szmitkowski M. Vitamin B12 concentration in the blood 2010;28(164):122-5. Pol Merkur Lekarski
• Baumgartner A, Rommelspacher H, Otto M, et al. Hypothalamic pituitary thyroid (HPT) axis in chronic alcoholism. I. HPT axis in chronic alcoholics during withdrawal and after 3 weeks of abstinence. Alcohol- ism: 1994;18(2):284-94. Experimental Research
• Schulte MT, Ramo D, Brown SA. Gender differ- ences in factors influencing alcohol use and drinking progression among adolescents. Clinical Psychology Review 2009;29(6):535-47.
• Miller WR, Westerberg VS, Harris RJ, Tonigan JS. What predicts relapse? Prospective testing of ante- cedent models. Addiction 1996;91(suppl):155-7.