title: [Excessive alcohol consumption: what is the burden on natural caregivers?].
abstract: BACKGROUND
  Data on the natural caregivers burdened by the excessive consumption of alcohol by members of the family circle or friends in the general population are lacking. Therefore, our aim was twofold: (i) to assess the burden of individuals with excessive alcohol consumption on natural caregivers and (ii) to examine the factors explaining the association between alcohol consumption and the level of burden.
  
  
  METHODS
  Data were derived from a national representative survey of the French adult population, conducted in 2013, that involved 1018 participants who had in their close environment a person consuming excessive amounts of alcohol. The level of burden was assessed using the Zarit Burden Scale (ZBI).
  
  
  RESULTS
  The average score of the ZBI was 28.5 (SE=16.0). The average volume of alcohol consumed per day, heavy drinking days, as well as the consumers' profiles defined by the AUDIT-C were significantly associated with the level of burden. Following adjustments for the participants' characteristics and for the closeness between participants and individuals with excessive consumption, these associations remained significant. Following adjustments for these variables as well as demographic, social, behavioral and medical characteristics of individuals with excessive consumption, the associations between the level of burden and respectively consumers' profiles and heavy drinking days remained significant. At last, following adjustments for social, behavioral and medical characteristics of individuals with excessive consumption and for the closeness between them and participants, only the association between heavy drinking days and the level of burden remained significant.
  
  
  CONCLUSIONS
  One out of five participants having in their close environment a person consuming excessive amount of alcohol reported an important burden. The association between the individuals' alcohol intake and the level of burden for natural caregivers was mainly influenced by social, behavioral and medical consequences of alcohol consumption and by the physical and affective proximity between them. Furthermore, we found that the AUDIT-C scores could define alcohol consumers' profiles which form a continuum in terms of the level of burden, even after adjustments for potentially confounding variables. At last, the high prevalence of psychological complications in participants calls for greater recognition of the natural caregivers' burden in the management of patients with alcohol dependence.
authors.affiliation: Service de psychiatrie de l'adulte et du sujet âgé, hôpital Corentin-Celton, groupe hospitalier des hôpitaux universitaires Paris-Ouest, Assistance publique-Hôpitaux de Paris (AP-HP), 4, parvis Corentin-Celton, 92130 Issy-les-Moulineaux, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Inserm, centre de psychiatrie et neurosciences, UMR 894, 75014 Paris, France. Electronic address: nico.hoertel@yahoo.fr.
authors.forename: N
authors.initials: N
authors.lastname: Hoertel
authors.affiliation: Lundbeck SAS, 37-45, quai du Président Roosevelt, 92445 Issy-Les-Moulineaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Crochard
authors.affiliation: Service de psychiatrie de l'adulte et du sujet âgé, hôpital Corentin-Celton, groupe hospitalier des hôpitaux universitaires Paris-Ouest, Assistance publique-Hôpitaux de Paris (AP-HP), 4, parvis Corentin-Celton, 92130 Issy-les-Moulineaux, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Inserm, centre de psychiatrie et neurosciences, UMR 894, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Limosin
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Inserm, centre de psychiatrie et neurosciences, UMR 894, 75014 Paris, France; Clinique des maladies mentales et de l'encéphale (CMME), groupe hospitalier Sainte-Anne, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Rouillon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D054541:Family Conflict / Q000523:psychology; D005260:Female; D005602:France; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Aidants; Alcohol drinking; Alcohol-induced disorders; Alcool; Burden; Caregivers; Consommation à risque; Conséquences sociales; Dépendance; Entourage; Famille; Fardeau; Social problems