[High rates of inpatient readmissions of alcohol addicted patients - heavy users or chronically ill patients?]

In alcohol addiction inpatient treatment an increase of readmissions is noted since years.

Because little is known about the psychosocial and psychiatric background of addictive patients with many readmissions, this study aimed at a comprehensive psychiatric and psychological description of those patients.

Consecutively admitted alcohol addicted patients to the department of addictions of a German psychiatric hospital were allocated to a group with more than three previous treatments in 12 months before index admission (heavy user; n = 37) and a control group of patients with not more than one previous admission in the last year (n = 42). Patients were comprehensively interviewed with standardised psychiatric and neuropsychological instruments (ASI, cognitive skills) as well as with questionnaires for assessment of subjective psychopathology, quality of life and confidence of abstinence.

Patients with many readmissions were chronically ill addictives with severe social, physical and mental disabilities as consequences of alcohol consumption. In subjective experience of quality of life, psychopathology and confidence of abstinence heavy users did not differ from the control group. Heavy users showed significantly less cognitive skills.

For chronically ill alcohol addicted patients alternatives to the repeatedly used standard acute treatment must be developed.