Comorbid Psychiatric Diagnoses Among Individuals Presenting to an Addiction Treatment Program for Alcohol Dependence

Abstract

A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.

RÉSUMÉ

Comorbidité dans la dépendance d’alcool

Diagnostics psychiatriques CoMorbides parmi des individus présent à un programme de traitement de penchant pour la dépendance d’alcool

Une revue rétrospective de disque de patient a été conduite pour examiner des diagnostics psychiatriques Comorbides, et l’utilisation Comorbide de substance, parmi 465 patients au-dessous de 45 ans, présentant à une unité nationale de traitement de penchant d’alcool à Dublin, entre les années de 1995 et de 2006. Les taux étaient hauts pour le désordre dépressif (25.3%) en particulier parmi les femelles (35.4%). L’utilisation rapportée par vie des substances autres que l’alcool était 39.2%, et davantage d’analyse a montré des taux sensiblement plus élevés d’individu-mal délibéré parmi ce groupe. L’utilisation rapportée par vie de l’extase a été également sensiblement associée à la dépression et au l’individu-mal délibéré dans cette population dépendante d’alcool en utilisant l’analyse logistique de régression. Des implications et les limitations des résultats sont discutées.

Mots-clés la dépendance d’alcool; diagnostic Comorbide; diagnostic duel; utilisation de substance; extase

RESUMEN

Co-morbosidad en dependencia del alcohol

Diagnosis psiquiátricas Co-Mórbidas entre los individuos que presentan a un programa del tratamiento del apego para la dependencia del alcohol

Una revisión retrospectiva del expediente del paciente fue conducida para examinar diagnosis psiquiátricas co-mórbidas, y uso co-mórbido de la sustancia, entre 465 pacientes bajo 45 años, presentando a una unidad nacional del tratamiento del apego del alcohol en Dublín, entre los años de 1995 y 2006. Las tarifas eran altas para el desorden depresivo (25.3%) particularmente entre las hembras (35.4%). El uso divulgado curso de la vida de sustancias con excepción del alcohol era 39.2%, y el análisis adicional demostró índices perceptiblemente más altos del uno mismo-daño deliberado entre este grupo. El uso divulgado curso de la vida del ecstasy también fue asociado perceptiblemente a la depresión y al uno mismo-daño deliberado en esta población dependiente del alcohol usando análisis logístico de la regresión. Las implicaciones y las limitaciones de los resultados se discuten.

Palabras claves dependencia del alcohol; diagnosis co-mórbida; diagnosis dual; uso de la sustancia; ecstasy

Keywords :

• alcohol dependence
• comorbid diagnosis
• dual diagnosis
• ecstasy
• substance use

THE AUTHORS

John Lyne, MRCPsych, obtained his Bachelor of Medical Science degree in 2002, completing a thesis on the neuropharmacology of schizophrenia. He graduated from the University College Dublin School of Medicine in 2004, and subsequently spent time working in emergency and general medicine in Sydney, Australia. He returned to Ireland to commence a career in psychiatry, and has published in the fields of addictions and liaison psychiatry. He is currently a clinical fellow in the DETECT Early Intervention in Psychosis Service in Dublin, Ireland.

Brian O’Donoghue, MRCPsych, qualified from the University College Dublin in 2004 and completed his basic specialist training in the St John of God Psychiatry rotation. He is currently a clinical fellow with the Detect Early Intervention for Psychosis Service in Dublin, Ireland. His interests include psychosis and the study of coercion and involuntary admissions.

Maurice Clancy, MRCPsych, graduated from the University College Cork Medical School in 2005. He subsequently commenced psychiatry training, and has presented addiction and liaison psychiatry research at international conferences. He is currently working as a forensic psychiatry registrar with the Irish National Forensic Mental Health Service, and is undertaking neuropsychiatry research in Beaumont Hospital, Dublin.

Colin O’Gara, MRCPsych, is a Consultant Psychiatrist and researcher with responsibility for the addiction unit at St. John of God Hospital, Stillorgan, Co. Dublin, Ireland. He was previously a clinical research fellow at the National Addiction Centre, Institute of Psychiatry, King's College London. He leads the multidisciplinary clinical and research activities in addiction sciences including the 28-day group therapy program, population genetic studies, addiction epidemiology, and relapse prevention studies. He completed postgraduate psychiatric clinical training at the Maudsley Hospital, London, where he was also prominent in training doctors for postgraduate psychiatric examinations.