Study calls for more intensive psychotherapeutic support for patients with alcohol addiction

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The mortality of alcohol dependent patients in general hospitals is many times higher than that of patients without alcohol dependency. In addition, they die about 7.6 years earlier on average than hospital patients without a history of alcohol addiction. This is what scientists from the Department of Psychiatry and Psychotherapy of the University of Bonn Hospital together with British colleagues discovered using patient data from various general hospitals in Manchester (England). The researchers are calling for earlier and more intensive psychotherapeutic support of persons with alcohol addictions. The study is published in the journal "European Psychiatry".

How can I get hold of some alcohol? Addicts' thoughts increasingly focus on this question. As the compulsive drinking behavior increases, other interests are ignored. Typically, persons affected tend to deny their addiction and suffer from withdrawal symptoms and the habituation to alcohol consumption increases. Moreover, alcoholism leads to changes in personality as well as to family and workplace problems.

"Mental problems as well as significant physical health impairments are associated with alcohol addiction," says Dr. Dieter Schoepf from the Department of Psychiatry and Psychotherapy of the University of Bonn Hospital. "Alcoholics who were treated in British general hospitals for health problems die an average of 7.6 years earlier than non-alcohol dependent patients; this is due to the interaction of several concomitant physical illnesses," reports the scientist. For the study, Dr. Schoepf and Prof. Dr. Reinhard Heun from the Royal Derby Hospital in England evaluated patient data from seven general hospitals in Manchester.

This is a long-term observational study: The data extend over a 12.5-year period. Using these data, the scientists analyzed comorbid physical illnesses of 23,371 hospital patients with alcohol dependence and compared them with those of a control group of 233,710 randomly selected patients without alcoholism. Prof. Heun summarized the result: "During the observation period, approximately one out of five hospital patients with alcoholism died in one of the hospitals, while only one out of twelve patients in the control group died."

27 concomitant illnesses occur more frequently with alcohol addiction

A total of 27 physical illnesses occur more often in patients with alcohol addiction: the liver, the pancreas, the airways, the gastrointestinal tract and the nervous system. In contrast to this, heart attacks, cardiovascular disease and cataracts, for instance, occurred less frequently in patients with alcoholism than in the control group. "Patients with addiction problems are often admitted to hospitals as emergency cases. At the time of diagnosis, priority is then given to the acute symptoms - this may contribute to the fact that not all physical illnesses are recorded," suspects Dr. Schoepf. Reduced pain sensations and perception disorders of addicted persons can also cause certain conditions to not be detected by doctors.

The study is unique in this form, the scientists emphasized. The large number of patients included and the comprehensive control group enabled a highly sophisticated assessment. The long observation period, which is unusual for such investigations, also made it possible to also record illnesses for which symptoms develop only gradually. The fact that the investigation was performed with data from Great Britain is mainly related to the easier access to the necessary information in England. "The results indeed relate to general hospitals in Manchester, however they are representative because of the large numbers of random samples and can therefore be transferred to other general hospitals in other countries," says Dr. Schoepf.

Researchers call for screening and the administration of therapies early on

From the scientists' standpoint, the elevated mortality of patients with alcohol dependence in general hospitals makes it clear that addiction as a major cause of the multiple physical consequences must be treated at a significantly earlier stage. "Through diligent screening and early treatment of concomitant mental and physical illnesses, it should be possible to significantly increase the life expectancy of alcoholic patients," says Prof. Heun.

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