THE CO-OCCURRENCE OF ALCOHOLISM WITH OTHER PSYCHIATRIC-DISORDERS IN THE GENERAL-POPULATION AND ITS IMPACT ON TREATMENT
THE CO-OCCURRENCE OF ALCOHOLISM WITH OTHER PSYCHIATRIC-DISORDERS IN THE GENERAL-POPULATION AND ITS IMPACT ON TREATMENT
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DOI：
10.15288/jsa.1988.49.219
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发表时间：
1988-05-01
期刊：
影响因子：
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通讯作者：
PRYZBECK, TR
中科院分区：
文献类型：
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作者：
HELZER, JE;PRYZBECK, TR
从先前对临床人群的研究中可以明显看出，酗酒和其他精神病诊断之间的共病率很高。然而，这可能只是Berkson偏见的一种表达（即，以及具有多种诊断的人寻求和接受治疗的趋势增加，从而落入从治疗来源抽取的研究人群中）。在这篇文章中，我们使用流行病学汇水区调查的数据，以检查酒精滥用和依赖，其他物质滥用和非物质精神疾病之间的共病，在一个样本中，约20,000人从一般人群。我们还研究了合并症对精神病治疗的影响。我们检查的每一个精神病诊断都更有可能发生在酗酒者身上，而不是非酗酒者身上。与反社会人格障碍、其他物质使用和躁狂症的关联尤其强烈。酗酒和抑郁症之间的联系是积极的，但不是很强。其他疾病的存在增加了酗酒者利用治疗服务的可能性，但并没有增加将饮酒问题告知医生的可能性。这一发现证实了先前在临床样本中对合并症的研究，并建议医生需要提高对酒精中毒的警惕。
it is apparent from previous studies in clinical populations that there is a high comorbidity rate between alcoholism and other psychiatric diagnoses. However, this may simply be an expression of Berkson''s bias (i.e., and increased tendency for persons with multiple diagnoses to seek and receive treatment and thus fall into study populations drawn from treatment sources). In this article, we use data from the Epidemiologic Catchment Area survey to examine the comorbidity between alcohol abuse and dependence, other substances of abuse and nonsubstance psychiatric disorders in a sample of approximately 20,000 persons drawn from the general population. We also examine the effect of comorbidity on psychiatric treatment. Every one of the psychiatric diagnoses we examined was more likely to occur in alcoholics than in nonalcoholics. Associations were particularly strong with antisocial personality disorder, other substance use and mania. The association between alcoholism and depressive disorders was positive but not very strong. The presence of other illnesses increased the likelihood of utilization of treatment services by alcoholics but did not increase the likelihood that drinking problems would be communicated to a doctor. The findings confirm prior studies of comorbidity in clinical samples and suggest the need for increased vigilance toward alcoholism by physicians.