Sarin S K, Sachdev G, Jiloha R C, Bhatt A, Munjal G C
Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India.
Dig Dis Sci. 1988 Apr;33(4):443-8. doi: 10.1007/BF01536029.
Fifty-six male patients with alcoholic liver disease were evaluated for the presence and severity of alcohol dependence and psychiatric illness using a severity of alcohol dependence questionnaire and research diagnostic criteria, respectively. Forty-three (76.7%) patients were found to be dependent; 26 (46.4%) moderately, and 17 (30.3%) severely. Patients with alcoholic hepatitis were significantly (P less than 0.05) more often found to be dependent than patients with alcoholic cirrhosis. Psychiatric morbidity was observed in 42 (75%) of the patients with alcoholic liver disease and 15 (26.7%) of the nonalcoholic cirrhotics. The difference was highly significant (P less than 0.01). The commonest disorders in patients with alcoholic liver disease were neuroses (33.0%), followed by affective disorders (26.8%). It was, however, not possible to ascertain whether psychiatric disorders antedated alcoholism or were secondary to it. Detection of moderate to severe dependence on alcohol and psychiatric morbidity in about three-fourths of the patients with alcoholic liver disease warrants an increased awareness and a multidisciplinary approach for the management of these patients.
使用酒精依赖严重程度问卷和研究诊断标准，分别对56例酒精性肝病男性患者的酒精依赖和精神疾病的存在情况及严重程度进行了评估。发现43例（76.7%）患者存在依赖；26例（46.4%）为中度依赖，17例（30.3%）为重度依赖。与酒精性肝硬化患者相比，酒精性肝炎患者被发现存在依赖的比例显著更高（P<0.05）。在酒精性肝病患者中有42例（75%）观察到精神疾病，在非酒精性肝硬化患者中有15例（26.7%）观察到精神疾病。差异非常显著（P<0.01）。酒精性肝病患者中最常见的疾病是神经症（33.0%），其次是情感障碍（26.8%）。然而，无法确定精神疾病是先于酒精中毒出现还是继发于酒精中毒。在约四分之三的酒精性肝病患者中检测到中度至重度酒精依赖和精神疾病，这就需要提高对这些患者的认识，并采用多学科方法进行管理。
