Alcohol problems in psychiatric patients: 5-year course.

Little is known about the occurrence and course of alcohol problems in patients with affective syndromes treated in psychiatric facilities. We have shown previously that a high proportion of such patients abused alcohol. In a 5-year follow-up of patients in the initial study, a large majority had a remission of their alcohol problems lasting at least 6 months, although many of these patients had subsequent relapses. Using survival analyses, we found that alcohol dependence indicators, previous chronicity of alcohol problems, and a diagnosis of schizoaffective disorder predicted poor outcome (specifically, longer time to remission of the alcohol problems). However, these factors were unrelated to receiving alcohol-specific treatment during the 5 years. Severity of social/occupational alcohol problems did not predict poor outcome, but did predict alcohol-specific treatment (detoxification, rehabilitation, Alcoholics Anonymous [AA], or Antabuse).