Comorbility in inpatients alcoholics. Clinical and social implications

Abstract

A significant comorbility can be seen in a retrospective analysis of 188 admissions, diagnosed as alcoholism (DSM-IV), in the Psychiatric Unit of a General Hospital during the period from 1996-1998, in both physical and psychiatric illnesses. Comorbidity and admission loading varied according to the type of alcoholism. In a detailed review of the clinical histories, and in accordance with the (WHO) ICD-10 criteria on alcohol consumption, the three diagnoses found were: Drunkenness (DR), Harmful Use (HU) and Dependency (D). Each of the three groups presented a specific profile with sociodemographic differences, and in the associated physical and psychiatric illnesses. The DR Group was the youngest, presented more sociofamiliar integration, had very short admissions, and did not present comorbidity. The HU Group had an average age of 34 years, obvious signs of a lack of sociolaboral integration and a significant psychiatric comorbidity, and presented greater admission loading. The D Group was the oldest, presented high physical comorbidity, good family but bad occupational integration, and the most frequent psychiatric diagnosis was that of affective disorder. Not including the type of alcoholism, according to the DSM-IV, leads to errors of evaluation and interpretation in large numbers of samples of alcoholics, errors that we frequently found in reviewing the literature.