Browsing by Author "Cherpitel, C.J."

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A case-crossover study of acute alcohol use and suicide attempt
(ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV, C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA, 2004) Borges, G.; Cherpitel, C.J.; MacDonald, S.; Giesbrecht, N.; Stockwell, T.; Wilcox, H.C.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Objective: Several studies have shown that acute alcohol use is associated with suicidal behavior, but the magnitude and nature of the relationship remain unclear. We report a study on the impact of acute alcohol use on suicide attempts treated in the emergency room (ER) using the case-crossover design. Method: Seven ER studies carried out in the United States, Canada, Mexico and Australia from 1984 to 1996 with probability samples and similar methodology were merged yielding a total of 102 suicide attempters (overall 52% were male and 59% under 30 years of age). Results: Thirty-six patients reported alcohol use within 6 hours prior to the suicide attempt. When usual alcohol consumption during the past 12 months served as the control value, the estimated relative risk (RR) for patients who reported alcohol use within 6 hours prior to the suicide attempt was 9.6 (95% confidence interval: 5.7-16.3). Although the prevalence of alcohol use differed by sex, there was no statistically significant difference in the estimated RRs (RR = 13.6 men and RR = 5.3 women, p = 0.11 for the heterogeneity test). Conclusions: A positive association was found between alcohol use 6 hours prior and suicide attempts in 102 ER cases in four countries. The case-crossover methodology is well suited to studies for which an external control group is not easily obtainable.
A comparison of substance use and injury among Mexican American emergency room patients in the United States and Mexicans in Mexico
(2001) Cherpitel, C.J.; Borges, G.; Public Health Institute, Alcohol Research Group, Berkeley, California 94709-2176, USA.; ccherpitel@arg.org
A cross-national meta-analysis of alcohol and injury: data from the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP)
(2003) Cherpitel, C.J.; Bond, J.; Ye, Y.; Borges, G.; MacDonald, S.; Giesbrecht, N.; Public Health Institute Alcohol Research Group 2000 Hearst Avenue Berkeley, CA 94709 USA; ccherpitel@arg.org
Acute alcohol use and suicidal behavior: A review of the literature
(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA, 2004) Cherpitel, C.J.; Borges, G.L.G.; Wilcox, H.C.; Alcohol Res Grp, Natl Alcohol Res Ctr, Berkeley, CA 94709 USA; ccherpitel@arg.org
Background: Both acute and chronic use of alcohol are associated with suicidal behavior. However, the differing relationship of each component of alcohol use and possible causal mechanisms remain unclear. Methods: This article reviews and summarizes associations between acute alcohol consumption (with and without intoxication) and suicidal behavior (both completed suicide and suicide attempts) among adults 19 years and older, as presented in literature published between 1991 and 2001. Possible mechanisms and methodologic challenges for evaluating the association are also discussed. An application of a research design (the case-crossover study) that has the potential for addressing the effects of acute alcohol use over and above usual or chronic use is presented. Results: The majority of articles reviewed were restricted to descriptive studies that documented the prevalence of suicide completers or attempters who tested positive for alcohol use. A wide range of alcohol-positive cases were found for both completed suicide (10-69%) and suicide attempts (10-73%). Common methodologic limitations included the lack of control groups (for evaluating risk conferred by alcohol use), selection and ascertainment bias, and small sample sizes. The results of the case-crossover pilot study indicated substantially higher risk of suicide during or shortly after use of alcohol compared with alcohol-free periods. Conclusions: Although there is a substantial literature of published studies on acute alcohol use and suicidal behavior, the majority of studies focus on completed suicide and report prevalence estimates. Findings from such studies are subject to several possible sources of bias and have not advanced our knowledge of mechanisms in the association between acute alcohol use and suicidal behavior. The case-crossover design may help to overcome some limitations of these studies and facilitate evaluation of associations and possible causal mechanisms by which acute alcohol use is linked to suicidal behavior.
Acute alcohol use and the risk of non-fatal injury in sixteen countries
(WILEY-BLACKWELL, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA, 2006) Borges, G.; Cherpitel, C.J.; Orozco, R.; Bond, J.; Ye, Y.; MacDonald, S.; Giesbrecht, N.; Stockwell, T.; Cremonte, M.; Moskalewicz, J.; Swiatkiewicz, G.; Poznyak, V.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Aims To determine the relative risk (RR) of non-fatal injury associated with alcohol consumption in a series of emergency departments (EDs), possible effect modifiers and the impact of contextual variables on differences across sites. Design The case-crossover method was used to obtain RR estimates of the effect of alcohol on non-fatal injuries. Meta-analysis was used to evaluate the consistency and magnitude of RR across sites, and the extent to which contextual variables explain differences in effect sizes. Participants Probability samples of 11 536 injured patients attending 28 EDs studies in 16 countries (1984-2002). The majority of the sample was male (65%) and > 30 years old (53%). Measurements Exposed cases where those that consumed alcohol 6 hours prior to the injury. Usual alcohol consumption served as the control period. Findings Drinking within 6 hours prior to the injury was reported by 21% of the sample. The estimated (random) pooled relative risk for patients who reported alcohol use within 6 hours prior to injury was 5.69 (95% confidence interval = 4.04-8.00), ranging from 1.05 in Canada to 35.00 in South Africa. Effect size was not homogeneous across studies, as societies with riskier consumption patterns had a higher relative risk for injury. Heavier drinkers also showed lower RR. Conclusions Acute alcohol was a risk factor for non-fatal injuries in most sites. Policy measures addressed to the general population are recommended, especially in societies with riskier consumption patterns.
Alcohol consumption and casualties: a comparison of emergency room populations in the United States and Mexico
(1990) Cherpitel, C.J.; Rosovsky, H.; Alcohol Research Group, Medical Research Institute of San Francisco, Berkeley, California 94709.
Cross-national performance of the RAPS4/RAPS4-QF for tolerance and heavy drinking: Data from 13 countries
(ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV, C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA, 2005) Cherpitel, C.J.; Ye, Y.; Bond, J.; Borges, G.; Cremonte, M.; Marais, S.; Poznyak, V.; Sovinova, H.; Moskalewicz, J.; Swiatkiewicz, G.; Alcohol Res Grp, Berkeley, CA 94709 USA; ccherpitel@arg.org
Objective: There are little data available on the performance of brief screening instruments for alcohol-use disorders crossnationally; therefore, we analyzed the performance of one such instrument in a number of countries. Method: Performance of the RAPS4 for tolerance and the RAPS4-QF for heavy drinking are analyzed from emergency room data across 13 countries included in the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injuries. Results: The RAPS4 showed good sensitivity and specificity for tolerance across most of the countries, but was higher in countries that were higher on societal-level detrimental drinking patterns. Prevalence of tolerance was also higher in those countries with high detrimental drinking pattern scores. Sensitivity of the RAPS4-QF for heavy drinking was uniformly high across countries, while maintaining good specificity, and did not vary by detrimental drinking patterns. Conclusions: Findings suggest the RAPS4 and RAPS4-QF may hold promise cross-nationally. Future research should more fully address the performance of brief screening instruments for alcohol-use disorders (using standard diagnostic criteria) cross-nationally, with consideration of the impact of societal drinking patterns.
Drinking in the injury event: A comparison of Mexican-American male ER patients in the United States and in Mexico
(2002) Cherpitel, C.J.; Borges, G.; Alcohol Research Group, Berkeley, California; ccherpitel@arg.org
Emergency room injury presentations as an indicator of alcohol-related problems in the community: A multilevel analysis of an international study
(ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV, C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA, 2004) Young, D.J.; Stockwell, T.; Cherpitel, C.J.; Ye, Y.; MacDonald, S.; Borges, G.; Giesbrecht, N.; Curtin Univ Technol, Nat Drug Res Inst, Perth, WA 6001, Australia; timstock@uvic.ca
Objective: This study describes and examines the development of surrogate measures of acute alcohol-related injury for use in the evaluation of community-based prevention initiatives. Method: An international collaborative study of alcohol and injury, the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP), provided a subset of data on 8,580 emergency room (ER) presentations from five countries and 28 ER facilities. Results: Presentations most likely to be alcohol related were those made between 12:00 AM and 4:59 AM (56%), on Fridays, Saturdays or Sundays (26%); and those among injured persons who were male (28%), who were aged between 18 and 45 years (24%) or who were unmarried (24%). Multilevel logistic regression models confirmed the significance of the above variables as predictors of alcohol involvement prior to the injury event. The strongest predictor variable was presentation between 12 midnight and 4:59 AM with an odds ratio of 4.92 (Wald Test chi(2) = 397.6 p <.001). Being male had an odds ratio of 3.01 (Wald Test chi(2) = 247.25,p <.001), and presenting on a Friday, Saturday or Sunday night had an odds ratio of 1.50 (Wald Test chi(2) = 49.6, p <.001), whereas being under 45 (odds ratio [OR] = 1.20, p <.05) and being unmarried (OR = 1.2, p <.01) were less strong predictors. Combining all these values for variables raised the probability of prior alcohol involvement in such injury presentations to 0.65, although only 3.37% of all cases met these criteria, limiting applicability of this combined variable as a surrogate measure for intervention studies. Probabilities of prior alcohol involvement are presented with other combinations of values for the predictor variables. Conclusions: Frequency of night-time injury presentations to ER facilities, particularly by men, can be used as a reliable surrogate measure of alcohol-related injuries for various epidemiological and evaluation purposes.
Episodic alcohol use and risk of nonfatal injury
(OXFORD UNIV PRESS INC, JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA, 2004) Borges, G.; Cherpitel, C.J.; Mondragón, L.; Poznyak, V.; Peden, M.; Gutiérrez, I.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Usual and acute alcohol consumption are important risk factors for injury. Although alcohol-dependent people are thought to be at increased risk of injury, there are few reports suggesting that their risk is greater than that of nondependent alcohol users in a given episode of alcohol use. The authors conducted a case-crossover analysis of data on 705 injury patients from a hospital emergency department in Mexico City, Mexico, collected in 2002. The majority of the sample was male (60%) and over 30 years old (51%). With use of a multiple matching approach that took into account three control time periods (the day prior to the injury, the same day in the previous week, and the same day in the previous month), the estimated relative risk of injury for patients who reported having consumed alcohol within 6 hours prior to injury (17% of the sample) was 3.97 (95% confidence interval: 2.88, 5.48). This increase in the relative risk was concentrated within the first 2 hours after drinking; there was a positive association of increasing risk with increasing number of drinks consumed. These data suggested that relative risk estimates were the same for patients with and without alcohol use disorders.
Multi-level analysis of causal attribution of injury to alcohol: Data from two international emergency room projects
(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA, 2005) Cherpitel, C.J.; Bond, J.; Ye, Y.; Borges, G.; Room, R.; Poznyak, V.; Hao, W.; https://doi.org/10.1016/j.drugalcdep.2005.10.002; Alcohol Res Grp, Berkeley, CA 94709 USA; ccherpitel@arg.org
Performance of screening instruments for alcohol problems in the ER: a comparison of Mexican-Americans and Mexicans in Mexico
(2000) Cherpitel, C.J.; Borges, G.; Public Health Institute, Alcohol Research Group, Berkeley, California, USA.
Screening for drug use disorders in the emergency department: performance of the rapid drug problems screen (RDPS)
(ELSEVIER IRELAND LTD, ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND, 2004) Cherpitel, C.J.; Borges, G.; Inst Publ Hlth, Alcohol Res Grp, Berkeley, CA 94709 USA; ccherpitel@arg.org
Little research is available on brief screening instruments for identify those meeting diagnostic criteria for drug dependence or abuse. A brief, four-item screening instrument, called the rapid drug problems screen (RDPS), was developed from a similar instrument for alcohol use disorders, the rapid alcohol problems screen (RAPS). Performance of the RDPS was evaluated against DSM-IV and ICD-10 criteria for drug dependence and for dependence or abuse in a sample of 703 emergency department patients in Mexico City. Among males, sensitivity and specificity were 91 and 96%, respectively, for dependence and 93 and 96%, respectively, for dependence or abuse. Neither of the two females meeting diagnostic criteria for dependence or abuse were identified by the RDPS. Area under the receiver-operating characteristic curve indicates an optimum cut point of 1. The data suggest that the RDPS may hold promise as a brief screening instrument for substance use among males, but should be tested in larger populations of females meeting diagnostic criteria for drug use disorders, and across ethnic subgroups in other geographic locales. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
Screening instruments for alcohol problems: a comparison of cut points between Mexican American and Mexican patients in the emergency room
(2000) Cherpitel, C.J.; Borges, G.; Public Health Institute, Alcohol Research Group, Berkeley, California 94709-2176, USA.
Selection of screening items for alcohol abuse and alcohol dependence among Mexicans and Mexican Americans in the emergencydepartment
(2001) Borges, G.; Cherpitel, C.J.; Mexican Institute of Psychiatry, Calzada Mexico-Xochimilco, Mexico DF.; guibor@imp.edu.mx
Substance use among emergency room patients: an exploratory analysis by ethnicity and acculturation
(2002) Cherpitel, C.J.; Borges, G.; Public Health Institute, Alcohol Research Group, Berkeley, California, USA.; ccherpitel@argo.org
The causal attribution of injury to alcohol consumption: A cross-national meta-analysis from the Emergency Room Collaborative Alcohol Analysis Project
(2003) Cherpitel, C.J.; Ye, Y.; Bond, J.; Borges, G.; Alcohol Res Grp, Inst Publ Hlth, Berkeley, CA 94709 USA
The criteria for causation of alcohol in violent injuries based on emergency room data from six countries
(PERGAMON-ELSEVIER SCIENCE LTD, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND, 2005) MacDonald, S.; Cherpitel, C.J.; Borges, G.; DeSouza, A.; Giesbrecht, N.; Stockwell, T.; Univ Western Ontario, Ctr Addict & Mental Hlth, London, ON N6G 4X8, Canada; scotm@uwo.ca
This paper is based on data using similar methods collected from patients at 30 emergency rooms (ERs) in six countries. These data were analyzed with the goal of determining whether alcohol is a likely cause of violence through an application of criteria outlined by Bradford Hill [Proc. R. Soc. Med. 58 (1966) 295]. Analyses were conducted by comparing various measures of alcohol involvement in violent versus accidental injuries. The results supported temporal sequence of events and specificity. The odds ratios of violent versus accidental injury for a blood alcohol concentration (BAC) over 80 mg% were significant for each country, ranging from 2.77 for Mexico to 9.45 for Canada, which supports both the strength of associations and the consistency of findings. No third variables were found from the logistic regression analysis that better explain the relationships between alcohol and violence. A significant dose-response relationship between BAC level and violence was also found. All analyses conducted point to a causal role of alcohol in injuries related to violence. (C) 2004 Elsevier Ltd. All rights reserved.
The risk of intentional injury with acute and chronic alcohol exposures: A case-control and case-crossover study
(ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV, C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA, 2003) Vinson, D.C.; Borges, G.; Cherpitel, C.J.; Univ Missouri, Dept Family & Community Med, Columbia, MO 65212 USA
Objective: Alcohol is associated with intentional injury, but most studies have operationalized it as alcoholism and have not examined acute exposure. The study aimed to clarify the relative contributions of drinking over a few hours and of alcohol use disorders to the risk of intentional injury inflicted by another person. Method: The study used a case-control design with two control groups: (1) Community controls matched to cases, and (2) the cases themselves, comparing consumption on the day of injury with consumption on previous days, in a case-crossover comparison. Cases were patients with an acute injury presenting to any of the three emergency departments in one county; 102 had an intentional injury. Community controls (N= 1,856) were recruited by random-digit dialing. Recent alcohol consumption was recorded in self-reported standard drinks. Current alcohol use disorders were defined using DSM-IV criteria. Results: In the case-control analysis, drinking in a 6-hour window was associated with risk of intentional injury (odds ratio [OR] = 10, 95% confidence interval [Cl]: 4.7-22). In case-crossover comparison of the cases' own drinking in the 6 hours prior to injury with their own drinking the day before, the OR was 34 (95% Cl: 4.7-250). In case-control analyses, alcohol dependence was associated with intentional injury (OR = 6.0, 95% CI 3.5-10), but alcohol abuse was not (OR = 0.7, 95% CL 0.4-1.3). Conclusions: Drinking over a few hours is strongly associated with intentional injury. Current alcohol dependence is also, but with a lower OR. The findings may have implications for efforts to prevent intentional injury.
Violence related injuries in the emergency room: Alcohol, depression, and conduct problems
(INFORMA HEALTHCARE, TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND, 2004) Borges, G.; Cherpitel, C.J.; Medina-Mora, M.E.; Mondragón, L.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Objective. The aim of this study was to obtain epidemiological measures of the association between alcohol consumption and emergency room (ER) attendance due to violence, compared to the general population in the city of Pachuca, Mexico, during October-November, 1996 and June July, 1997. Method. The study was a population-based case-control design. Intervention and Measurements: Data consisted of an interviewer-administered questionnaire, collected on a 24-h basis, during the entire week. Setting and Participants: Cases were 127 patients (78% male) admitted to the ER because of an injury that was the result of violence (being in a fight or being attacked by someone). A sample of residents from Pachuca (n = 9120) was the comparison group. Results. Patients reporting drinking within 6h compared to nondrinkers were more likely to suffer a violence-related injury [34.0 (17.5-66.2)] and alcohol dependent patients were more likely to be involved in a violence-related injury [7.4 (3.5-15.6)] compared to noncurrent drinkers. When both alcohol prior and alcohol dependence were considered simultaneously in multiple models among current drinkers, patients with violence-related injuries were more likely to report alcohol prior but not to be positive for alcohol dependence. Depressive symptoms, but not conduct problem behavior, were also associated with violent injury in simultaneous regressions that included alcohol variables. Conclusions. In the city of Pachuca, Mexico, a large relationship between drinking prior to the event and violence-related injury, regardless of alcohol dependence, was found. Depression was also related to violence, suggesting the need for more comprehensive intervention with these patients.