title: [Chronic alcoholic patients with multiple comorbidity. Community outpatient evaluation of a recommendation for operationalized diagnosis and alternative models].
abstract: To improve reliability of diagnosis of a specific subgroup of chronic alcoholics with multiple impairments (CMA), operational criteria have been proposed. To evaluate usability and sensitivity vs. specificity, all in-patients fulfilling ICD-10 criteria of alcohol dependence were screened on two randomly chosen dates. Two clinically "extreme" groups were extracted: patients in a 8-week short-term residential treatment vs. patients in a residential program specifically designed for chronic alcoholics with severe somatic, psychic and/or social consequences. More quantitative operational criteria, such as "treatment experience" and "consumptive behaviour" revealed much lower discriminative power than more qualitative criteria, such as "comorbidity" and "social and legal status". Substantially revised and simplified operational criteria exhibited comparable sensitivity and specificity for the classification of chronic alcoholics with multiple impairments (CMA).
mesh_terms: D000437:Alcoholism / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000534:rehabilitation; D000553:Ambulatory Care; D003131:Combined Modality Therapy; D015897:Comorbidity; D004185:Disability Evaluation; D005858:Germany; D006304:Health Status; D006767:Hospitals, District; D006801:Humans; D010343:Patient Admission; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D011567:Psychiatric Department, Hospital; D012017:Referral and Consultation; D015203:Reproducibility of Results; D019966:Substance-Related Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation