Ticehurst S
Hunter Area Mental Health Service, Newcastle, NSW.
Aust N Z J Psychiatry. 1990 Jun;24(2):252-60. doi: 10.3109/00048679009077690.
Alcohol abuse and dependence are the third most common psychiatric diagnoses in elderly men in the community, occurring in 3% over the age of 65. Elderly patients may present in a number of atypical guises to medical, social, psychiatric and forensic services. When they do, their alcohol problem is often missed. They have high rates of physical morbidity and are most often found in the general hospital setting. While there is a steady decline in consumption and alcohol-related problems with age, up to a third of elderly abusers take up drinking in late life, possibly in response to psychosocial stressors. Recognition has been a major barrier to effective management. Intervention studies point to difficulties in attracting patients to treatment, with little consensus on treatment regimes or goals. Given these problems, a regionally based service responsible for identifying and managing alcohol abuse in the elderly is proposed. Such a service could improve liaison with community and hospital-based programmes and allow practical research to be undertaken into this enigmatic problem.
酒精滥用和酒精依赖是社区老年男性中第三常见的精神疾病诊断，65岁以上人群中的发生率为3%。老年患者可能以多种非典型的形式出现在医疗、社会、精神和司法服务机构。当他们就诊时，其酒精问题往往被忽视。他们身体发病率高，且大多出现在综合医院。虽然随着年龄增长，饮酒量和与酒精相关的问题呈稳步下降趋势，但高达三分之一的老年酗酒者是在晚年开始饮酒的，这可能是对心理社会压力源的反应。识别是有效管理的主要障碍。干预研究指出，吸引患者接受治疗存在困难，对于治疗方案或目标几乎没有共识。鉴于这些问题，建议设立一个负责识别和管理老年酒精滥用问题的区域服务机构。这样的服务机构可以改善与社区和医院项目的联络，并允许针对这个难以捉摸的问题进行实际研究。
