Comorbid anxiety and affective disorder in alcohol-dependent patients seeking treatment: the first Multicentre Study in Germany.

The goals of this study were to describe demographic variables, drinking history, and the 6-month prevalence of Axis I comorbidity among alcohol-dependent subjects in GERMANY: The variables: amount of alcohol consumption, age at onset of the first alcohol consumed, age at onset of daily alcohol consumption, age at onset of withdrawal symptoms and number of detoxifications were related to the different comorbid disorders and gender. In this study, 556 patients from 25 alcohol treatment centres were enrolled between 1 January 1999 and 30 April 1999. After a minimum of 10 days of sobriety patients who fulfilled ICD-10 and DSM-IV criteria of alcohol dependence were interviewed for data collection using the Mini-DIPS (German version of the Anxiety Disorders Interview Schedule) and a standardized psychosocial interview. The 6-month prevalence of comorbid Axis I disorders was 53.1%. Among the patients with comorbidity, affective and anxiety disorders were most frequent. Comorbid stress disorder was associated with an early start of drinking, an early beginning of withdrawal symptoms, highest number of detoxifications, and the highest amount of alcohol consumed. Female patients with anxiety disorder consumed more alcohol and started earlier than females without this comorbid disorder. The data do not answer the question of the pathogenesis of comorbid disorders and alcoholism, but indicate that stress disorders in alcoholic patients and anxiety disorders in female alcoholics influence the course and severity of alcoholism.

[Admission status of alcohol and drug-dependent patients in "high threshold" access to withdrawal treatment]. / Die Aufnahmesituation alkohol-und medikamentenabhängiger Patienten bei"hochschwelligem" Zugang zur Entzugsbehandlung.

OBJECTIVE AND METHODS: 106 patients (64.2% male and 35.8% female) who applied for a withdrawal treatment by phone call, were interviewed concerning the admission context with the aim to find out whether the admission regulations prevent patients from undergoing treatment. RESULTS: 72.6% of all patients were admitted as inpatients. The average waiting period was 8 days. 15.1% were known to have previously suffered from conclusions and 4.7% from delirium tremens; for these patients, the waiting period was significantly shorter. CONCLUSIONS: High-threshold admission is not an insurmountable difficulty. Waiting periods and soberness at admission are accepted. Setting up admission conditions is, on the one hand, justified, whereas on the other hand chronic patients are often not reached. Telephone contacts with patients willing to undergo treatment should be replaced by contacts in an outpatient setting.

[A multi-stage treatment concept for alcoholics: utilization and results of treatment]. / Ein mehrstufiges Behandlungsangebot für Alkoholkranke: Inanspruchnahme und Behandlungsergebnisse.

A multistage treatment model for alcoholics that is situated close to their domicile is presented in respect of organisational structure and basic therapeutic principles. Patients are compared with each other in their various stages of treatment (detoxication, counselling, therapy, aftercare) in respect of sociodemographic, alcohol-specific and psychological variables; these variables are examined with regard to their prognostic relevance for the transition to the next stage of their treatment schedule and for the success of the treatment. The resulting consequences for the treatment of alcoholics are pointed out and discussed.

Congruence of personality assessments within families with a schizophrenic son.

Following the phenomenological approach to interaction in psychiatrically disturbed families a personality questionnaire ('Giessen Test') was used to assess the views three family members (father, mother, son) had of themselves and of each other. These views may be regarded as quite stable results of interaction processes, so that conclusions about family interaction patterns may be drawn from the level of concordance of any two of them. Comparisons were made between families in which a son had been hospitalized for the first time with a diagnosis of schizophrenia and those in which a son had been hospitalized for surgical treatment, n = 30 in each category. The psychiatric patients did not on the whole give distorted personality descriptions. But in the index families the relationship between father and son was found characteristically different from that in the control families. This fact is interpreted as a reaction of the father to the deviant behaviour of the son, who did not conform with the male sex-role expectations of the father. The father as it is could not then identify with his son as a father usually does and perhaps necessarily should. The answers of the mothers partly confirm this conclusion. With regard to the parental dyad, the findings suggest that the fathers' needs for reciprocal consideration are not met by their wives.

[A holiday with psychiatric long-term patients (author's transl)]. / Ein Ferienaufenthalt mit psychiatrischen Langzeitpatienten.

Following predominantly favourable earlier experiences with holiday trips, eleven long-term hospitalized patients of sociopsychiatric ward (an institution concerned with the gradual transition from psychiatric treatment to social rehabilitation) went on a one week's trip together with the ward personnel, emphasis being on the aspect of recreation. The patients themselves took over the organization of the daily schedules. Marked improvements in mood levels, a decrease in disturbances of well-being, and increased activity were clearly noticeable. These were probably due to relief from the clinic's daily routine and to the intensification of interactions within the patient group and with the therapists. Although these changes did not persist in most patients after their return, a positive effect for further therapy planning was seen in at least four of them. This experience report concludes with a suggestion to include such trips in the proposed treatment schedule for long-term patients.