Alcoholism among outpatients with psychiatric morbidity

Area of Science:

• Public Health
• Psychiatry
• Substance Abuse Research

Background:

• Psychiatric disorders are prevalent in rural Kenyan healthcare settings.
• Alcohol abuse often presents as physical, social, or psychological issues, leading to underdiagnosis.
• Locally brewed beverages with variable ethanol content are commonly consumed.

Purpose of the Study:

• To determine the prevalence of psychiatric morbidity in rural Kenyan outpatients.
• To identify the proportion of patients with alcohol-related disorders.
• To evaluate the utility of the brief MAST screening tool for alcoholism.

Main Methods:

• A two-stage screening procedure was administered to 881 outpatients in four rural Kenyan district hospitals.
• Psychiatric morbidity was assessed, followed by specific screening for alcohol use disorders using the Michigan Alcoholism Screening Test (MAST).
• Alcohol-related disorders were classified according to ICD-9 criteria.

Main Results:

• Overall psychiatric morbidity was found in 24.9% of the outpatients.
• Alcohol-related disorders accounted for 12.7% of the total psychiatric morbidity.
• The brief MAST proved to be a rapid and effective tool for identifying potential alcoholics.

Conclusions:

• Alcohol abuse is a significant, often undetected, public health issue in rural Kenya.
• Primary health workers (PHW) require enhanced training for effective detection and management of alcohol-related disorders.
• Addressing alcohol abuse necessitates greater attention from health planners and primary healthcare providers.