Comparison of alcohol-dependent patients at a gastroenterological and a psychiatric ward according to the Lesch alcoholism typology: implications for treatment.
OBJECTIVE
To assess the clinical and biological status of alcohol-dependent patients admitted to a psychiatric or a gastroenterological ward, assessing and comparing dimensions important for prescribing treatment for withdrawal and relapse prevention.


METHODS
Eighty patients, alcohol-dependent according to international classification of diseases tenth revision and diagnostic and statistical manual, text revised, version IV, admitted to the Vienna General Hospital between January 2005 and  November 2006, were examined, of whom 44 were admitted to the psychiatric ward and 36 to the gastroenterological ward. Dimensions of alcohol dependence were assessed using a computerized structured interview, the Lesch alcoholism typology (LAT). Biological markers and the model for end-stage liver disease (MELD) score defined the severity of alcohol-related physical disturbances.


RESULTS
As might be expected, gastroenterological patients had more advanced physical diseases than psychiatric patients, and affective disorders and suicidal tendencies were significantly commoner among the psychiatric patients. Thus, LAT Type II patients were overrepresented at the gastroenterological ward and LAT Type III patients at the psychiatric ward.


CONCLUSIONS
The severity of somatic diseases and psychiatric disorders as well as the distribution of the four types according to Lesch differ between alcohol-dependent patients admitted to a psychiatric ward or a gastroenterological ward. Regarding the positive long-term outcome, different evidence-based medical treatment approaches for withdrawal and relapse prevention are needed for these patients.
Vyssoki
Benjamin
B
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria. benjamin.vyssoki@meduniwien.ac.at
Steindl-Munda
Petra
P
Ferenci
Peter
P
Walter
Henriette
H
Höfer
Peter
P
Blüml
Victor
V
Friedrich
Fabian
F
Kogoj
Dagmar
D
Lesch
Otto M
OM
D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003663:Decision Trees; D005260:Female; D005762:Gastroenterology; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D011567:Psychiatric Department, Hospital; D012720:Severity of Illness Index; D016896:Treatment Outcome