Psychiatric co-morbidity and aftercare among alcoholics: a prospective study of a nationwide representative sample.
OBJECTIVE
To study prospectively the type and extent of aftercare sought by patients following their admission for alcohol and other substance abuse treatment as a function of psychiatric co-morbidity.


METHODS
Prospective cohort study with follow-up after 16 months.


METHODS
A nationwide sample of alcoholics discharged from inpatient treatment (N = 351) in Iceland.


METHODS
The Diagnostic Interview Schedule was used to assign psychiatric diagnoses at the time of index admission. A questionnaire on the type and number of aftercare attendances was mailed to all participants to obtain information about aftercare.


RESULTS
A combination of attendance at Alcoholics Anonymous (AA) and professional care was the most common aftercare (49%); while only 8% received no aftercare whatsoever. The mean number of AA attendances was over 24 while it was less than 3 for the various professional appointments. Patients with a diagnosis of schizophrenia had a lower rate of attendance at AA. Other types of co-morbidity did not affect AA attendance but did increase rates of professional help-seeking.


CONCLUSIONS
Better professional treatment attendance might be gained by integrating AA concepts while AA might benefit from professional input to address the prevalent co-morbid psychiatric disorders.
D000328:Adult; D000359:Aftercare; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology / Q000534:rehabilitation*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales