T. Vannucchi, G. Villani - Vol. 7, Settembre 2001, num.3
Testo Immagini Bibliografia Summary Riassunto Indice
Disturbi psichiatrici in una popolazione
di alcolisti: esiste una patogenesi comune?
Psychiatric disorders in an alcoholic sample:
is there a common pathogenesis?
It is commonly accepted that familiarity for alcohol abuse and psychiatric comorbidity are frequently associated with alcoholism. The aim of this work is to detect and evaluate the characteristics and correlations existing between psychiatric comorbidity, familiarity for alcohol abuse and mean daily assumption of alcohol (MDA). We evaluated a group of 69 patients (18 females and 51 males, mean age 42.5 years with a SD of 13.38) attending the Alcoholic Operative Unit (SERT) of Prato from October 1998 to October 1999. The following selection criteria were used: diagnosis of alcohol abuse according to DSM-IV and assumption of heavy doses (according to the guidelines of the Royal Colleges of Physicians, Psychiatrist and General Practitioners: > 24 gr/die in males and > 16 gr/die for females). All of the patients were anamnestically evaluated to detect psychiatric comorbidity (according to the DSM-IV criteria), familiarity for alcohol abuse and MDA. On the basis of the collected data and to detect correlations between the three factors the complete group was further subdivided into 8 subgroups: 1) patients with familiarity for alcohol abuse (F); 2) patients without familiarity for alcohol abuse (NF); 3) patients with familiarity but without psychiatric comorbidity (FNC); 4) patients with familiarity and comorbidity (FC); 5) patients with comorbidity (C); 6) patients without comorbidity (NC); 7) patients with comorbidity without familiarity (CNF); 8) patients without familiarity or comorbidity (NFNC). Familiarity is more represented in the group of alcoholics: 52 out of 69 (75.36%), but does not seem associated to MDA, that is 251.25 with a SD of 124.68, comparable to the mean value of the whole group (249.20 with a SD of 119.69). Comorbidity is present in 35 patients (50.72%) and seems associated directly with MDA, which is 275.86 with a SD of 136.74, significantly higher than the mean value of the group, while in the groups without comorbidity (NC, NCNF, NCF) the MDA is significantly lower (221.76 with a SD of 93.4, 245.83 with a SD of 108.08, 208.64 with a SD of 84.14 respectively). The group with both variables positive (comorbidity and familiarity) has the higher value of MDA (282.5 with a SD of 140.8). The group with comorbidity without familiarity is the smallest (5 patients, 7.25%), while the group with familiarity and comorbidity consists of 30 patients (43.48%). We can conclude that familiarity is an important risk factor to develop alcohol abuse, because a multifactorial more than purely genetic origin seems more probable. Comorbidity is another risk factor, but less significant than the previous one, and it influences the MDA. The sum of the two risk factors is associated to an even higher MDA.