This observational study estimates the extent to which alcohol disorder co-occurs in patients with major medical and psychiatric conditions. It looks at 2296 adult patients with hypertension, diabetes, heart disease (congestive heart failure or myocardial infarction) and/or current depressive disorder or subthreshold depressive symptoms, in the offices of general medical providers and mental health specialists in three U.S. cities. The authors compared the prevalence of alcohol co-morbidity in medically ill nondepressed patients of general medical providers and in depressed patients of both provider types. Results of the study show that patients with chronic medical problems or depression had similar levels of lifetime alcohol disorder (14 percent to 19 percent) and current alcohol problems (18 percent to 29 percent), 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 percent to 84 percent). The authors conclude that clinicians who treat patients with major medical and psychiatric conditions need to be prepared to identify and treat comorbid alcohol disorder.
Originally published in: Archives of Family Medicine, v. 2, November 1993, pp. 1142-1150.
This report is part of the RAND Corporation Reprint series. The Reprint was a product of the RAND Corporation from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.
Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.