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Title: The detection and treatment of alcohol dependence
Author: Chick, Jonathan Dale
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2008
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The cohesiveness of the proposed syndrome of alcohol dependence, and the evolution of symptoms over time, was validated in a clinical sample. In healthy individuals and in clinical samples, biological markers showed early signs of the syndrome in healthy men. Using general population data, and hospital data, we showed that heavier alcohol consumption predicted admission to a general hospital bed. Analysis of centrally collected data showed that the burden on Scottish hospitals due to alcohol problems rose in the last 40 years. In a randomized controlled trial we showed the value of intervening at an early stage in the career of a problem drinker. To treat more severe alcohol dependence, withdrawal symptoms must be controlled. We found an advantage of a longer-acting rather than a shorter-acting benzodiazepine. To help prevent relapse, ‘extended’ treatment emerged as only very marginally more effective than one session of firm advice to the patient to abstain. The medications disulfiram and naltrexone, if compliance was enhanced, were found to reduce relapse. (We found that selective serotonin re-uptake inhibitors were associated with more relapse.) Abstinence was accompanied by improvement in brain magnetic resonance parameters and cognitive testing. Analysis of studies of placebo-controlled treatment for alcohol dependence show that the costs of failure to help patients attain abstinence are much greater than the costs of effective treatments.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Sc.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available