Deprecated function: Return type of DatabaseStatementBase::execute($args = [], $options = []) should either be compatible with PDOStatement::execute(?array $params = null): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2246 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::current() should either be compatible with Iterator::current(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::rewind() should either be compatible with Iterator::rewind(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Behavioral Health
Alcohol use disorder: How best to screen and intervene
Ms. E was open to the idea of decreasing her alcohol use and agreed that she was depressed. Her lab tests at follow-up were normal other than an elevated AST/ALT of 90/80 U/L. She received brief counseling from her family physician combined with cognitive behavioral therapy by a psychologist colleague. A subsequent ultrasound of her liver showed mild hepatomegaly and moderate-to-severe steatosis with nodularity of the liver, raising the possibility of cirrhosis.
The NIAAA single-question screen asks how many times in the past year the patient had ≥4 drinks (women) or ≥5 drinks (men) in a day.
She continued to get counseling for her AUD and for her comorbid depression in addition to taking a selective serotonin reuptake inhibitor. She is now in early remission for her alcohol use.
CORRESPONDENCE Jaividhya Dasarathy, MD, Department of Family Medicine, Metro Health Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109; jdasarathy@metrohealth.org.
