| Objective: In humans, relapse behaviour is a ubiquitous problem for individuals"recovering"from alcoholism, since at least 60 to 80% of abstinent alcoholics will relapse during their lifetime because of various reasons. To know about abuse related factor, for establishing effective treatment recover measure very important. Cue-reactivity studies in the clinic show that these alcohol-associated cues can elicit reports of craving in human addicts. Alcohol dependent patients report craving if asked to hold and sniff their favourite drink or imagine/recall a situation in which they had a strong desire for alcohol. In recent years, abroad with various experiment pattern found environmental clue increased craving for alcohol,along with physiological , psychological and behaviour changes. Domestic similar research is not much. Here we present preliminary results characterizing alcohol dependent patients with regard to subjective and psycho physiological aspects of in a cue reactivity paradigm. To know the relationship between psychological craving and heart rate, blood pressure and serum cortical level among alcohol dependence during rehabilitation period. We compared the difference of craving and physiological indexes before and after exposure. To analysis from psychology, biology and sociology how environments clue increased craving for alcohol. Explore the relevance in self-report score changes and biological and psychological responses, finally provide the evidence of theory and experiment for preventing relapse and methods of detoxification.Method: Case-control study. 64 men who had entered the in-patient component of the Mental Health Institute at the First Hospital of Hebei Medical University were recruited for this study. They had to meet at least 5 criteria to be included according to DSM-IV criteria for dependence. All patients gave their written informed consent before participating in the study. The local Ethics Committee had approved the study protocol. Prior to inclusion in the study, all subjects underwent clinical detoxication according to routine procedures at the Mental Health Institute at the First Hospital of Hebei Medical University. Main exclusion criteria were the presence of a relevant axis I disorder such as major depression, bipolar disorder, any relevant anxiety disorder, psychotic disorders or other substance dependence. Also, patients with severe medical disorders or dementia of any etiology were excluded. According to random digital table 64 alcohol dependence patients divide into patient experiment group and patient compare group, two groups of each 32 patients. Control subjects (n=32) were recruited as healthy volunteers meeting criteria for neither harmful use nor dependence. The age, gender and cultural background matched with patient group .All subjects supplied demographic information and data on past history of medical and psychiatric problems, drinking and drug use patterns and any history of psychiatric disorders. To remove the biological section influence for the physiological indexes such as blood pressure and hormone, cue exposure was always performed at the same time of day 16:00. All subjects have been tried relax train 15 minutes. To record heart rate with 12 lead electrocardiogram instrument, according to the method that WHO hypertension expert committee recommends, use the type sphygmomanometer of mercury column that rectified, measure blood pressure. Before measuring at least sit quietly 15 minutes, do not smoke. To measure the three times seat right blood pressure of upper arm, take average. Take out to take the vein blood of left arm, with full automatic chemiluminescence's enzyme immunity analyser detect cortisol. Above-mentioned is the physiological index of base line; Then, Subjects were asked to rate their desire for an alcoholic drink on a 100mm visual analogue scale (Like scale) reaching from"no desire"(extreme left) to"maximum desire"(extreme right). After a baseline session (no cue), patient experiment group were exposed by sight and smell to their favourite alcoholic beverage (alcoholic cue). Patient compare group were exposed by sight and smell to tea or milk (neutral cue). Control subjects were exposed by sight and smell to alcoholic beverage (alcoholic cue). Each cue exposure lasted exactly 1 minute. All subjects were asked to rate their desire for an alcoholic drink on Likert-scale measure and were recorded physiological index (blood pressure, heart rate, cortisol) after cue exposure and at the week of 1st and 4th.Own data use SPSS13. 0 statistical software packages make statistics, initially the homogeneity of variance among all the groups was analysed. All the measurement data was expressed as mean standard deviation(mean±SD). with the t test compare environmental clue to expose for alcohol dependence on psychology craving and the influence of each physiological index (heart rate, blood pressure and cortisol). The related factors to cue-elicited alcohol craving have been screened by step-wise correlation.Results:1 With compare group and patient normally compare group compare , the craving and the physiological index (blood pressure, heart rate, cortisol) of patient experiment group exposes in related environmental clue after first day change than base line , increased significantly (P<0.05).2 The craving and the physiological index (blood pressure, heart rate, cortisol) of patient experiment group exposes in related environmental clue after the day of 1th, the week of 1th and the week of 4th have the tendency that reduces gradually. In the day of 1th, every index with the week of 1th and the week of 4th is compared with , has significance discrepancy ( P < 0.05 ) .In the week of 1th , every index discrepancy of the week of 4th do not have significance. 3 All the patients during rehabilitation period have more craving and their serum cortical levels were higher than those of normal control group(P<0.05).Conclusions:Craving and the change of some physiolo -gical indexes can been elicited by alcohol-related cue. Psychological craving and heart rate, blood pressure and serum cortisol level among alcohol dependence have the tendency that reduces gradually after exposes in related environmental clue. most of alcohol dependence during rehabilitation period have strong psychological craving and high serum cortical levels. The serum cortical level maybe one of biological marks of relapse trend. |
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