Sherbourne C D, Hays R D, Wells K B, Rogers W, Burnam M A
RAND, Santa Monica, Calif.
Arch Fam Med. 1993 Nov;2(11):1142-50. doi: 10.1001/archfami.2.11.1142.
To estimate the extent to which alcohol disorder co-occurs in patients with major medical and psychiatric conditions.
Observational study.
Offices of general medical providers and mental health specialists in three US cities.
Adult patients (N = 2296) with hypertension, diabetes, heart disease (congestive heart failure or myocardial infarction), and/or current depressive disorder or subthreshold depressive symptoms.
Current and lifetime alcohol disorder, alcohol consumption, current problem drinking, perceived need for help for alcohol or other drug problems, and unmet need.
Comparisons of the prevalence of alcohol comorbidity in medically ill nondepressed patients of general medical providers and in depressed patients of both provider types.
Patients with chronic medical problems or depression had similar levels of lifetime alcohol disorder (14% to 19%) and current alcohol problems (18% to 29%), but depressed patients were more likely to report needing help for problems with alcohol or drugs. Current alcohol disorder was more prevalent among depressed patients in mental health specialty practices than in general medical practices. Many patients who perceived a need for care for alcohol and other drug problems reported that this need was unmet (37% to 84%).
Clinicians who treat patients with major medical and psychiatric conditions need to be prepared to identify and treat comorbid alcohol disorder.
评估酒精障碍在患有主要内科和精神疾病的患者中同时出现的程度。
观察性研究。
美国三个城市的普通医疗服务提供者办公室和心理健康专家办公室。
患有高血压、糖尿病、心脏病（充血性心力衰竭或心肌梗死）和/或当前患有抑郁症或亚阈值抑郁症状的成年患者（N = 2296）。
当前和终生酒精障碍、酒精消费量、当前问题饮酒、对酒精或其他药物问题寻求帮助的感知需求以及未满足的需求。
比较普通医疗服务提供者的非抑郁内科疾病患者和两种类型服务提供者的抑郁患者中酒精共病的患病率。
患有慢性内科疾病或抑郁症的患者终生酒精障碍水平（14%至19%）和当前酒精问题水平（18%至29%）相似，但抑郁患者更有可能报告需要酒精或药物问题方面的帮助。心理健康专科诊所的抑郁患者中当前酒精障碍比普通医疗诊所更普遍。许多认为需要酒精和其他药物问题护理的患者报告这种需求未得到满足（37%至84%）。
治疗患有主要内科和精神疾病患者的临床医生需要准备好识别和治疗共病的酒精障碍。
