Miloš Židanik
Health centre Maribor
Sodna ulica 13
2000 Maribor

 
Key words: alcohol-related disorders, comorbidity, psychiatry, diagnostics, therapy

Abstract:  

Background. The aim of this article is the analysis of patients with alcohol-related disorders that were send in ambulatory care unit to verify the characteristics of the population and their treatment-choice.

Methods. All patients with alcohol-related disorders (n =189) were analysed and followed up from 12 – 30 months. For the diagnostics ICD-10 and DSM-IV criteria were used. The level of cognitive functioning was established clinically.

Results. There were 189 patients with alcohol-related problems, 7,5% of all patients that made an appointment in psychiatric ambulatory care. Among them were 154 male (81,5%) and 35 women (18,5%) The mean age of man was 44,6 ± 10,5 years and women 47,5 ± 11,5 years. The difference was significant (p <0,01). Patients from the sample had significant lower education level compared with the general population (p <0,003). 58,2% of patients had dual or multiple diagnosis. Most common were depression (26,5%) and personality disorders (29,1%). The sub sample of women was at higher risk: women came later to the psychiatrist and had a higher proportion of depression (37,1% against 24% at man, p =0,0000). The most common motive for the medical visit was the necessity of evaluation of invalidity (20,6%). At 25,1% of the patients a lower cognitive level functioning was established. 10% came to the appointment under the influence of alcohol. The majority came in the practice only once or twice: 63,5% of patients from the sample. The drop-out between the 2.nd and 6.th month was 40,6% and from the 7.th to 12.th month 26,8%. After the first year only 15,9% were still in the treatment. Only 7,9% of the sample took part in a group therapy, which is the first choice treatment for alcoholics.

Conclusions. People with alcohol-related problems are at high risk for developing different mental disorders. They have less coping skills: they do achieve lower education levels, because of prolonged drinking there is a secondary decline of cognitive functioning and among them there is a high proportion of personality disorders. Therefore seeking help from socio-economic problems and problems at working place through medicine and status of invalidity is a natural consequence. The data show that people with alcohol-related problems are seeking help from psychiatrists too late and without an autonomous motivation for change. They decline the need for intensive treatment of alcoholism. Regarding the high risk of this specific population (high mortality and comorbidity), there is a necessity for a better co-operation with general practitioners for a better recognition and treatment plan for this population.