[Diagnostics and treatment of alcohol-related disorders: results of a representative study in psychiatric and psychotherapeutic practices].
BACKGROUND
Alcohol use disorders (AUD) are of high prevalence in the community. The aim of the present study is to examine the diagnostic and therapeutic strategies of psychiatrists and psychotherapists in patients with AUDs.


METHODS
A standardized questionnaire was sent to all psychiatrists and psychologists in the South Badenia region (n = 745). It consisted of general questions and those regarding diagnostic and therapeutic procedures in the last patient seen with an AUD. A total of 224 questionnaires sent back by 160 psychotherapists [PT] and 64 psychiatrists [P] could be included in the analysis.


RESULTS
The mean stated prevalence of AUDs was 5 %. The mean age of the reported patient was 44 +/- 10 years, 60 % were men. The initial reason for consultation in psychotherapy was in 61.9 % depression in comparison to 40.7 % psychiatry (p < or = 0,01). The majority of patients seen by psychiatrists (44.1 %) were referred by their general practitioners. Standardised screening instruments were rarely used. The concordance of the diagnostic judgement and formal ICD 10-criteria was 74.5 % [P] vs. 45.5 % [PT] (p </= 0,001). 60 % [P] and 24.1 % [PT] were referred to addiction counselling services (p < or = 0,001). Patient related factors were largely seen as major impediments for adequate diagnosis and treatment.


CONCLUSIONS
The study demonstrates significant differences in the patient population and the diagnostic and therapeutic strategies in the two groups of therapists. Many aspects of the data point towards the need to improve networking and to integrate services to be able to provide better care for patients with AUDs.
Berner
M M
MM
Universitätsklinikum Freiburg, Abteilung für Psychiatrie und Psychotherapie, Sektion Klinische Epidemiologie und Versorgungsforschung, Freiburg, Germany. michael.berner@uniklinik-freiburg.de
Langlotz
M
M
Kriston
L
L
Härter
M
M
D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003627:Data Interpretation, Statistical; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011570:Psychiatry; D011613:Psychotherapy; D011795:Surveys and Questionnaires