The role of problem drinking in psychiatric admissions.
The role of problem drinking in psychiatric admissions.
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饮酒问题在精神病入院中的作用。
DOI：
10.1046/j.1360-0443.1995.9033757.x
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Schmidt,LA
中科院分区：
文献类型：
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作者：
Schmidt,LA
尽管有问题的饮酒者在美国各地的精神科治疗人群中所占比例过高，但尚不清楚这主要是由于难以区分诊断酒精和精神问题以及高合并症率，还是由于酒精问题寻求帮助的独特因素。本文探讨了酒精问题在住院和门诊心理健康机构接受治疗方面所起的作用，考虑到饮酒问题的潜在作用，它既是患者认为需要精神科医生帮助的状况，又是社会混乱的根源，促使其他人鼓励心理健康治疗。分析的重点是比较社区精神卫生系统中新入院患者的样本和居住在同一社区的患有高水平精神症状的未经治疗的个体。经历过饮酒问题造成的不良社会后果、相信饮酒导致了一个人的心理问题，以及之前有过针对饮酒问题进行心理健康治疗的经历，这些因素被发现与精神病入院呈正相关，而酗酒和依赖症状则不然。对导致精神病入院的事件的进一步分析表明，精神卫生系统在应对酒精问题方面的一个重要作用是遏制社区饮酒问题造成的社会混乱。研究发现，与酒精相关的精神病入院更频繁地涉及公共扰乱，引起警察或法院转介，并且更经常导致客户去上锁的医院病房，而不是精神健康门诊。
Although problem drinkers are over‐represented in psychiatric treatment populations throughout the United States, it is unclear whether this is primarily due to difficulties in differentially diagnosing alcohol and mental problems and to high rates of comorbidity, or to factors unique to help‐seeking for alcohol problems. This article examines the role that alcohol problems play in treatment entry to inpatient and outpatient mental health agencies, considering the potential roles of a drinking problem both as a condition perceived by the sufferer to require a psychiatrist's help, and as a source of social disruption that activates others to encourage mental health treatment. Analysis focuses on comparing samples of newly admitted patients in a community mental health system and untreated individuals with high levels of psychiatric symptoms living in the same community. Experiencing the adverse social consequences of a drinking problem, holding the belief that drinking has caused one's psychological problems, and having prior experiences in mental health treatment for a drinking problem are factors found to be positively associated with psychiatric admissions, while heavier drinking and dependence symptoms are not. Further analysis of events precipitating psychiatric admission suggests that an important role for the mental health system vis à vis alcohol problems is to contain social disruptions attributable to problem drinking in the community. Alcohol‐related psychiatric admissions are found to have more frequently involved public disruptions, to have elicited police or court referrals, and to have more often resulted in the client's going to a locked hospital ward, as opposed to a mental health outpatient clinic.