Is alcoholism a self-induced disease? A survey among doctors in Aarhus, Denmark and in Mainz, Germany

The intent of this study was to explore differences in views concerning the statements "alcoholism is a disease" and "alcoholism is a self-induced disease" among doctors in two cities from two contrasting countries, relating to different official definitions of alcoholism, namely Denmark, where alcoholism is related to ways of lifestyle and Germany, where alcoholism is related to preliminary diseases. The data come from a postal anonymous survey, carried out between January and February 2000 in Aarhus and Mainz, sent to general practitioners and hospital doctors from surgery, internal medicine and psychiatry. The identified sample was n = 572, and the response rate = 66% (n = 374). As opposed to doctors in Aarhus (73.7%), significantly more doctors in Mainz (92.4%) described alcoholism as a disease, but independent of nationality, about half of the samples (no gender, age and healthcare settings differences) also agreed that "alcoholism is a self-induced disease". The governmental position on alcoholism seems to have an influence on doctors' evaluation: in Denmark, where alcoholism is defined as a disease of lifestyle, doctors in Aarhus were less likely to describe alcoholism as a disease than in Mainz, where alcoholism is seen as a preliminary disease. The ideological background for these differences is connected to the different influence of the temperance groups on the alcohol field -- less in Denmark and more in Germany. However, half of the doctors in Aarhus and Mainz viewed alcoholism as a self-induced disease and so indirectly assumed that alcoholics are responsible for their self-afflicted disease.