CoMorbidity of Lifetime Psychiatric Disorder Among Male Alcoholic Patients (original) (raw)
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Journal of studies on alcohol, 1996
To examine the impact of three common comorbid disorders on a variety of outcomes 3 years after inpatient alcoholism treatment. Method: Using a prospective cohort design, we examined the frequency and intensity of drinking, the severity of alcohol-related symptoms, global alcohol-related outcome and severity of psychiatric symptoms in a group of 225 (74% male) alcoholics. At the index admission, patients were categorized as to the lifetime presence of major depression, antisocial personality disorder (ASP) and drag abuse/dependence. Multiple linear regression was used hierarchically to step in blocks of predictors in a logical sequence: (1) gender and age; (2) number of comorbid psychiatric diagnoses and the presence or absence of the three individual comorbid psychiatric disorders; and (3) the interaction between gender and each of the three diagnostic groups. Results: Men showed greater intensity of drinking, more alcohol-related symptoms and poorer global alcohol-related outcome. Younger patients also showed more alcohol-related symptoms. Although the number of comorbid diagnoses was correlated with both the intensity of drinking and the severity of psychopathology, each of the specific comorbid diagnoses accounted for unique variance in outcome. Comorbid drug abuse/dependence was associated with more drinking days and more alcohol-related symptoms. In contrast, the presence of comorbid major depression was associated with lower intensity of drinking. Finally, ASP was associated with poorer global alcohol-related outcome. Conclusions: Outcomes 3 years after alcoholism treatment are related to the presence of specific lifetime comorbid psychiatric diagnoses. Since such disorders may positively influence the course of alcoholism, trials of clinical interventions that target these disorders are warranted. (J. Stud. Alcohol 57: 619-626, 1996) IGH RATES of comorbid psychiatric disorders have been found in both clinical (Hesselbrock et al., 1985; Powell et al., 1982; Ross et al., 1988; Schuckit, 1985) and community samples of alcoholics (Helzer and Pryzbeck, 1988; Kessler et al., 1994). The most common comorbid disorders in many of these studies have been mood disorders (particularly depression), drug abuse and antisocial personality disorder (ASP). Although these comorbid psychiatric disorders are considered to be important both in the development of alcoholism and in its clinical course (Meyer, 1986; Pottenger et al., 1978), studies of their prognostic significance have not yielded consistent findings. In a 1-year follow-up study of alcoholics who had undergone extensive psychiatric assessment during their index treatment episode, Rounsaville and colleagues (1987) found that psychiatric diagnosis at intake predicted treatment outcome on a variety of measures. In addition, these investigators noted that them were a number of significant interactions between psychiatric diagnosis and gender. Among men, the presence of a comorbid lifetime diagnosis of major depres
Sub-diagnostic psychiatric comorbidity in alcoholics
Drug and Alcohol Dependence, 2007
Background-Psychiatric comorbidity in alcohol use disorders is clearly established, however most studies ignore data on psychiatric symptom counts that do not meet criteria for a diagnosis. We examined psychiatric symptom counts and psychological measures in the domains of anxiety, mood and externalizing pathology in 48 long-term abstinent alcoholics (LTAA) compared to 48 age/gender comparable light/non-drinking controls(NC).
Comorbidity of alcoholism and psychiatric disorders: an overview
Alcohol Research and …, 2002
Alcohol abuse and dependence frequently occur with other psychiatric conditions; this dual diagnosis is called comorbidity. Professionals working with comorbid patients face unique and challenging dilemmas about how to provide the best treatment to address both conditions. Despite ...
Drug and Alcohol Dependence, 2008
Background: Most alcoholism research in the U.S. uses convenience samples of treated alcoholics. The findings from treated samples have traditionally been applied to all alcoholics, including the 75% of alcoholics who are untreated. Improper generalization from select samples to an entire population is called 'Berkson's fallacy'. We compared untreated versus treated alcoholics, in order to ascertain whether both groups belonged to the same population with regard to psychiatric comorbidity. Methods: We compared psychiatric comorbidity in 1) active treatment-naive alcoholics (TNA; n = 86) 2) treated long-term abstinent alcoholics (TAA; n = 52) and 3) non-alcoholic controls (NAC; n = 118). We examined lifetime and current diagnoses, lifetime symptom counts, and psychological measures in the anxiety, mood and externalizing disorder domains. Results: TNA did not differ from NAC in psychiatric diagnosis rates, were abnormal compared to NAC on all psychological measures, had more externalizing symptoms than NAC, and showed a strong trend for men to have more symptoms in the mood and anxiety domains. TAA compared to TNA had higher diagnosis rates (all domains), symptom counts (all domains), and psychological measures of deviance proneness, but were comparable to TNA on anxiety and mood psychological measures. Conclusions: The abnormal thinking (psychological measures) in TNA (versus NAC) does not extend to behavior (symptoms) to the degree that it does in TAA. These results underline the importance of the use of subdiagnostic measures of psychiatric comorbidity in studies of alcoholics. The finding of lesser comorbidity in TNA versus TAA confirms the presence of Berkson's fallacy in generalizing from treated samples to all alcoholics.
Psychiatric Comorbidity Among Alcohol Dependents
Alcoholism: Clinical & Experimental Research, 2004
Methods: This cross-sectional study was conducted over a 6-month period. The Mini-International Neuropsychiatric Interview (MINI, version 5) was used to assess psychiatric comorbidity in 101 (male, n = 65; 64.5%) alcohol-dependent patients. Interviews were conducted after the first week of admission to ward 13. Results: Most participants (n = 63, 62.4%) had a co-occurring psychiatric disorder, the most common being major depressive (n = 30, 29.7%) and anxiety disorders (n = 43, 42.6%). Of the anxiety disorders, agoraphobia without a history of panic disorder (n = 10, 9.9%) and social phobia (n = 10, 9.9%) occurred most frequently, followed by generalised anxiety disorder (n = 9, 8.9%) and post-traumatic stress disorder (n = 9, 8.9%). Thirteen patients (13%) had a comorbid substance use disorder other than AUD. Conclusion: The prevalence of psychiatric comorbidity at this unit is high, especially among female patients. The findings emphasise a need to thoroughly assess patients and provide treatment and personnel who can manage the complex needs of a dual diagnosis patient population.
A study of psychiatric co-morbidity among alcohol dependents
International Journal of Research in Medical Sciences, 2017
Background: The alcohol use disorders are frequently associated with other co-morbid psychiatric disorders. The aim of this study was to describe the demographic variables, drinking history and psychiatric co-morbidity in alcohol dependent subjects. Methods: In this study, 40 consecutive patients were enrolled. After a minimum 1 month of sobriety, patients who fulfilled ICD-10 criteria of alcohol dependence were interviewed for data collection using Alcohol Use Disorders Identification Test (AUDIT), MINI-International Neuropsychiatric Interview (MINI) (Version-6.0) and a specially designed sociodemographic and clinical interview proforma. Subjects with substance use except tobacco were excluded from study. Main group comparison used chi-square test for categorical variables and the t-test for continuous variables. Results: Most of the patients studied were >40 years of age. Majority were employed (92%), lived in nuclear families (78%) and came from rural background (77.5%). Forty five percent of the patients initiated alcohol drinking between 16-25 years and reported peer pressure (50%) as most significant factor responsible for initiation of drinking alcohol. Mean age of developing alcohol dependence was 25.12 years (SD=4.28). Mean AUDIT score for subjects was 27.7 (SD=4.73). Lifetime psychiatric co-morbid disorders were detected in 45%. Psychiatric disorders most frequently associated with alcohol dependence were major depressive disorder (10%), bipolar affective disorder (7.5%), dysthymia (5%), anxiety disorders (7.5%) and antisocial personality disorder (5%). Conclusion: The study indicates that psychiatric disorders are prevalent in alcohol dependents and mood disorders are the most prevalent ones. It was also observed that co-morbid psychiatric disorders are associated with more severe alcohol problems.
A study of psychiatric comorbidity in alcohol dependence
Indian journal of psychiatry, 2003
The diagnosis of comorbid psychiatric conditions have important clinical ramifications as the outcome is poorer with multiple disorders. Various studies have shown that alcohol abuse has severe adverse effects on the course of metal illness and vice versa. Only a little data on the subject are available from our country. We interviewed 30 patients suffering from alcohol dependence using SCID - I & SCID - II. Seventy six percent of the sample had axis - I comorbid diagnosis and 40% had an axis -II diagnoses. Depressive disorder and cluster B personality disorders were the most common comorbid diagnosis.
Alcoholism and psychiatric comorbidity in general hospital inpatients
General Hospital Psychiatry, 1996
A substantial psychiatric comorbidity has been observed in alcohol patients from specialized alcoholism and substance abuse treatment centers. However, hardly any results have yet been reported from general hospital inpatients. We report results from a survey of a representative sample of 400 general hospital inpatients (200 medical, 200 surgical) which was carried out not only to assess the prevalence of alcoholism but also the rates of additional psychiatric disorders. All patients were interviewed personally with the Composite lnternational Diagnostic Interview (CIDl). A lifetime diagnosis of alcoholism was found in 18.8%, a current diagnosis in 11.3%.