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Alcohol problems in psychiatric patients: 5-year course
D S Hasin1, J Endicott, M B Keller
1Columbia University College of Physicians and Surgeons, School of Public Health, Division of Epidemiology, New York.
Comprehensive Psychiatry
|July 1, 1991
Summary
Many patients with affective syndromes experience alcohol problems, with most achieving remission. However, alcohol dependence and schizoaffective disorder indicate a poorer prognosis for alcohol problem remission.
Area of Science:
- Psychiatry
- Addiction Medicine
- Clinical Psychology
Background:
- Limited understanding of alcohol problem trajectories in psychiatric patients.
- Previous research indicated high rates of alcohol abuse in patients with affective syndromes.
Purpose of the Study:
- To investigate the occurrence and course of alcohol problems in patients with affective syndromes over a 5-year period.
- To identify predictors of remission and relapse for alcohol problems in this population.
Main Methods:
- A 5-year follow-up study of patients initially identified with affective syndromes and alcohol abuse.
- Utilized survival analyses to examine time to remission and factors influencing treatment engagement.
Main Results:
- A majority of patients achieved at least a 6-month remission from alcohol problems, though many experienced subsequent relapses.
- Alcohol dependence indicators, chronicity of alcohol problems, and schizoaffective disorder diagnosis predicted longer time to remission.
- Severity of social/occupational alcohol problems predicted receipt of alcohol-specific treatment but not remission outcome.
Conclusions:
- While remission is common, relapses are frequent in patients with affective syndromes and alcohol problems.
- Specific clinical factors predict a poorer course of alcohol problem remission, independent of treatment engagement.
- Social/occupational impairment is a relevant factor for initiating alcohol-specific interventions.