Comparison of alcohol-dependent patients at a gastroenterological and a psychiatric ward according to the Lesch alcoholism typology: implications for treatment

Alcohol Alcohol. 2010 Nov-Dec;45(6):534-40. doi: 10.1093/alcalc/agq059. Epub 2010 Sep 20.

Abstract

Aims: To assess the clinical and biological status of alcohol-dependent patients admitted to a psychiatric or a gastroenterological ward, assessing and comparing dimensions important for prescribing treatment for withdrawal and relapse prevention.

Methods: Eighty patients, alcohol-dependent according to international classification of diseases tenth revision and diagnostic and statistical manual, text revised, version IV, admitted to the Vienna General Hospital between January 2005 and November 2006, were examined, of whom 44 were admitted to the psychiatric ward and 36 to the gastroenterological ward. Dimensions of alcohol dependence were assessed using a computerized structured interview, the Lesch alcoholism typology (LAT). Biological markers and the model for end-stage liver disease (MELD) score defined the severity of alcohol-related physical disturbances.

Results: As might be expected, gastroenterological patients had more advanced physical diseases than psychiatric patients, and affective disorders and suicidal tendencies were significantly commoner among the psychiatric patients. Thus, LAT Type II patients were overrepresented at the gastroenterological ward and LAT Type III patients at the psychiatric ward.

Conclusion: The severity of somatic diseases and psychiatric disorders as well as the distribution of the four types according to Lesch differ between alcohol-dependent patients admitted to a psychiatric ward or a gastroenterological ward. Regarding the positive long-term outcome, different evidence-based medical treatment approaches for withdrawal and relapse prevention are needed for these patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Alcoholism / complications
  • Alcoholism / diagnosis
  • Alcoholism / therapy*
  • Decision Trees*
  • Female
  • Gastroenterology
  • Gastrointestinal Diseases / complications
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / therapy*
  • Hospitalization*
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • Middle Aged
  • Psychiatric Department, Hospital
  • Severity of Illness Index
  • Treatment Outcome