Herrold Amy A, Pape Theresa L-B, Li Xue, Jordan Neil
Center for Innovation for Complex Chronic Healthcare and Research Service, Edward Hines, Jr. VA Hospital, 5000 South 5th Avenue, Hines, IL 60141.
Cooperative Studies Program Coordinating Center, Edward Hines, Jr. VA Hospital, 5000 South 5th Avenue, Hines, IL 60141.
Mil Med. 2017 Jul;182(7):e1712-e1717. doi: 10.7205/MILMED-D-16-00360.
Probable alcohol use disorder (AUD), mental health disorders (MHDs), and mild traumatic brain injury (mTBI) are endemic among U.S. Veterans of the recent conflicts in Iraq and Afghanistan. Previous research demonstrates that recent Veterans with AUD and MHD both with and without mTBI (MHD ± mTBI) self-report higher alcohol craving levels relative to Veterans with AUD only. Since it is unknown if alcohol craving negatively impacts health-related quality of life (HRQOL), the purpose of this study is to identify and describe the relationship between alcohol craving and HRQOL for recent Veterans with AUD alone and those with AUD and co-occurring conditions.
This cross-sectional study included Penn Alcohol Craving Scale (PACS) and Veterans RAND 36 Item Health Survey mental and physical component score data collected among recent Veterans with AUD (N = 29, n = 27 males): 14 combat controls, 15 MHD ± mTBI. The Alcohol Use Disorder Identification Test, consumption questions determined AUD classification. That is only Veterans scoring a 4 or above for males and a 3 or above for females on the Alcohol Use Disorder Identification Test, consumption questions were included in this study. Associations between alcohol craving and HRQOL were examined using correlations and regression models.
There was a significant negative linear relationship between PACS and mental component score (p < 0.05) that did not significantly differ between groups. There was a significant negative curvilinear relationship between PACS and physical component score with a significant group effect.
Greater alcohol craving was associated with poorer mental HRQOL. Physical HRQOL was also significantly associated with alcohol craving. These relationships have important implications for clinical assessment and treatment among people with AUD. These findings suggest that alcohol craving is an important symptom of AUD for clinicians to assess and focus their treatment upon because it may negatively impact HRQOL.
在美国参与伊拉克和阿富汗近期冲突的退伍军人中，酒精使用障碍（AUD）、精神健康障碍（MHD）和轻度创伤性脑损伤（mTBI）较为普遍。先前的研究表明，近期患有AUD和MHD（无论有无mTBI）的退伍军人（MHD±mTBI）自我报告的酒精渴望水平高于仅患有AUD的退伍军人。由于尚不清楚酒精渴望是否会对健康相关生活质量（HRQOL）产生负面影响，本研究的目的是确定并描述仅患有AUD的近期退伍军人以及患有AUD和共病情况的退伍军人中酒精渴望与HRQOL之间的关系。
这项横断面研究纳入了宾夕法尼亚酒精渴望量表（PACS）以及在近期患有AUD的退伍军人（N = 29，n = 27名男性）中收集的退伍军人兰德36项健康调查问卷的心理和身体成分得分数据：14名战斗对照者，15名MHD±mTBI患者。酒精使用障碍识别测试及饮酒问题确定了AUD的分类。也就是说，只有在酒精使用障碍识别测试及饮酒问题中男性得分4分及以上、女性得分3分及以上的退伍军人才纳入本研究。使用相关性和回归模型检验酒精渴望与HRQOL之间的关联。
PACS与心理成分得分之间存在显著的负线性关系（p < 0.05），各亚组之间无显著差异。PACS与身体成分得分之间存在显著的负曲线关系，且有显著的亚组效应。
更强的酒精渴望与较差的心理HRQOL相关。身体HRQOL也与酒精渴望显著相关。这些关系对AUD患者的临床评估和治疗具有重要意义。这些发现表明，酒精渴望是AUD的一个重要症状，临床医生应予以评估并将治疗重点放在这方面，因为它可能会对HRQOL产生负面影响。
