Latvian translation and adaptation for ASRS v1.1. symptoms checklist.

Background. Many studies show a link between attention deficit disorder (ADHD) and substance use disorders (SUD). SUD patients with ADHD tend to have worse treatment prognosis and higher relapse risk. Adult ADHD might be underdiagnosed among SUD patients in Latvia, as there are no diagnostic screening instruments for adult ADHD in Latvian. Identifying ADHD symptoms in SUD patients could help improve their treatment outcome and quality of life. Aim. To develop a Latvian translation and adaptation for Adult ADHD Self Report Scale (ASRS) v1.1. symptoms checklist Methods. A translation of ASRSv1.1 symptoms checklist from English to Latvian was made by a linguist naive to the purpose of translation and a psychiatrist. The translations were merged under guidance of a third linguist. Afterwards a backwards translation was made by a professor in English philology also blind to the purpose. An overall consensus was reached by an expert team to merge a polished translation. The instrument was given to focus group (Minnesota program psychotherapy ward patients) and university students to give a written feedback on clarity and comprehensibility of the translation and fill the first 6 screener questions from ASRSv1.1. Results. Of the 42 participants 31 were male, 11 – female, the mean age was 31.1. Out of 22 focus group patients, 5 (22%) screened positive for ADHD, out of 20 university students, 1 screened positive for ADHD. None expressed any difficulty in understanding or comprehending the instrument. Conclusion. Latvian version is a feasible adaptation of ASRSv1.1 symptoms checklist for the participants. Treatment-seeking SUD patients show to be a good focus group for further scientific research on ADHD. Further research should be carried out to validate the adapted versions of the instrument. Acknowledgements. The authors declare the absence of conflict of interest. The research did not receive any funding.publishersversionPeer reviewe

People with Alcohol Use Disorders in Specialized Care in Eight Different European Countries

Aim: To provide a description of patients receiving alcohol treatment in eight different European countries, including the level of comorbidities and functional limitations. Methods: Drinking behaviours, DSM-IV alcohol use disorder (AUD), mental and somatic comorbidities, disability and health services utilization of 1767 patients from various specialized treatment settings were assessed as representative for regions of eight European countries. Severity of alcohol dependence (AD) in terms of drinking level was compared with a large representative US sample. Results: Patients in specialized care for AUDs showed high levels of consumption [average level of daily ethanol intake: 141.1 g, standard deviation (SD): 116.0 g], comorbidity [e.g. liver problems: 19.6%, 95% confidence interval (CI): 17.5-21.6%; depression: 43.2%, 95% CI: 40.7-45.8%; anxiety: 50.3%, 95% CI: 47.8-52.9%], disability and health services utilization (average number of nights spent in hospital(s) during the last 6 months: 8.8, SD: 19.5 nights). Severity of AD was similar to the US sample, but European men consumed on average more alcohol daily. Conclusions: High levels of consumption, somatic and mental comorbidities, disability and functional losses were found in this representative treatment sample, indicating that treatment was initiated only at severe stages of AUDs. Earlier initiation of treatment could help avoid some of the health and social burde

Childhood risk factors for substance abuse in a clinical sample of adult outpatients in Riga Psychiatry and Addiction Medicine Centre symptoms checklist.

Background. Studies conducted in clinical populations suggest a strong connection between different childhood risk factors and substance use disorder (SUD) in adulthood. Aim. To examine the associations between self-reported weak academic performance, repetition of a grade, single-parent family, self–reported quality of parent–child relationship, conduct problems in childhood and SUD in adulthood in a sample of outpatients in the Addiction Outpatient Clinic in Riga, Latvia. Methods. Adult outpatients of addiction clinic were asked to complete a self-report survey. Healthy control subjects (adults without addiction, formally assessed for fitness to drive, firearms licensing etc.) and patients with substance use disorder were examined in relation to self-reported childhood risk factors. Results. Self-report surveys were completed by 334 outpatients (mean age 37.4; SD=10.1), including 97 healthy control subjects. 76.3 % of participants were male. The acquired data show significant connections between poor academic performance (p<0.000), repetition of a grade (p=0.001), conduct problems in childhood (p<0.000) and SUD in adulthood. Associations between single-parent family, low quality of parent–child relationship and substance abuse were insignificant. Males were found to be 1.5-fold more likely to have substance use disorder comparing to females (p=0.000). Conclusion. According to the obtained data, poor academic performance, repetition of a grade and conduct problems in childhood might be risk factors for developing SUD in adulthood. Children with these risk factors should be the target population for primary prevention of substance abuse. Acknowledgements. The authors declare the absence of conflict of interest.publishersversionPeer reviewe

General practitioners recognizing alcohol dependence: a large cross-sectional study in 6 European countries

PURPOSE Although alcohol dependence causes marked mortality and disease burden in Europe, the treatment rate is low. Primary care could play a key role in reducing alcohol-attributable harm by screening, brief interventions, and initiating or referral to treatment. This study investigates identification of alcohol dependence in European primary care settings. METHODS Assessments from 13,003 general practitioners, and 9,098 interviews (8,476 joint number of interviewed patients with a physician\u2019s assessment) were collected in 6 European countries. Alcohol dependence, comorbidities, and health service utilization were assessed by the general practitioner and independently using the Composite International Diagnostic Interview (CIDI) and other structured interviews. Weighted regression analyses were used to compare the impact of influencing variables on both types of diagnoses. RESULTS The rate of patients being identified as alcohol dependent by the CIDI or a general practitioner was about equally high, but there was not a lot of overlap between cases identified. Alcohol-dependent patients identified by a physician were older, had higher rates of physicial comorbidity (liver disease, hypertension), and were socially more marginalized, whereas average consumption of alcohol and mental comorbidity were equally high in both groups. CONCLUSION General practitioners were able to identify alcohol dependence, but the cases they identified differed from cases identified using the CIDI. The role of the CIDI as the reference standard should be reexamined, as older alcohol- dependent patients with severe comorbidities seemed to be missed in this assessment

People with alcohol use disorders in specialized care in eight different European countries

AIM To provide a description of patients receiving alcohol treatment in eight different European countries, including the level of comorbidities and functional limitations. METHODS Drinking behaviours, DSM-IV alcohol use disorder (AUD), mental and somatic comorbidities, disability and health services utilization of 1767 patients from various specialized treatment settings were assessed as representative for regions of eight European countries. Severity of alcohol dependence (AD) in terms of drinking level was compared with a large representative US sample. RESULTS Patients in specialized care for AUDs showed high levels of consumption [average level of daily ethanol intake: 141.1 g, standard deviation (SD): 116.0 g], comorbidity [e.g. liver problems: 19.6%, 95% confidence interval (CI): 17.5-21.6%; depression: 43.2%, 95% CI: 40.7-45.8%; anxiety: 50.3%, 95% CI: 47.8-52.9%], disability and health services utilization (average number of nights spent in hospital(s) during the last 6 months: 8.8, SD: 19.5 nights). Severity of AD was similar to the US sample, but European men consumed on average more alcohol daily. CONCLUSIONS High levels of consumption, somatic and mental comorbidities, disability and functional losses were found in this representative treatment sample, indicating that treatment was initiated only at severe stages of AUDs. Earlier initiation of treatment could help avoid some of the health and social burden