title: Alcohol Dependence, Co-occurring Conditions and Attributable Burden.
abstract: OBJECTIVE
  Alcohol dependence is associated with high rates of co-occurring disorders which impact health-related quality of life (HRQoL) and add to the cost-of-illness. This study investigated the burden of alcohol dependence and associated co-occurring conditions on health and productivity.
  
  
  METHODS
  A cross-sectional survey was conducted in eight European countries. Physicians (Psychiatrists and General Practitioners) completed patient record forms, which included assessment of co-occurring conditions, and patients completed matching self-completion forms. Drinking risk level (DRL) was calculated and the relationship between DRL, co-occurring conditions, work productivity, hospitalisations and rehabilitation stays was explored.
  
  
  RESULTS
  Data were collected for 2979 alcohol-dependent patients (mean age 48.8 ± 13.6 years; 70% male). In total, 77% of patients suffered from moderate-to-severe co-occurring psychiatric and/or somatic conditions. High DRL was significantly associated with depression, greater work productivity losses, increased hospitalisations and rehabilitation stays. Co-occurring conditions were significantly associated with poorer HRQoL and decreased work productivity, with a statistical trend towards an increased frequency of rehabilitation stays.
  
  
  CONCLUSIONS
  Alcohol-dependent patients manifest high rates of co-occurring psychiatric and somatic conditions, which are associated with impaired work productivity and HRQoL. The continued burden of illness observed in these already-diagnosed patients suggests an unmet need in both primary and secondary care.
authors.affiliation: Department of Public Health, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen K, Denmark brod@sund.ku.dk odlaug@gmail.com.
authors.forename: B L
authors.initials: BL
authors.lastname: Odlaug
authors.affiliation: Department of Psychiatry, Alcohol Unit, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gual
authors.affiliation: Adelphi Real World, Bollington, UK.
authors.forename: J
authors.initials: J
authors.lastname: DeCourcy
authors.affiliation: Adelphi Real World, Bollington, UK.
authors.forename: R
authors.initials: R
authors.lastname: Perry
authors.affiliation: Adelphi Real World, Bollington, UK.
authors.forename: J
authors.initials: J
authors.lastname: Pike
authors.affiliation: Adelphi Values, Bollington, UK.
authors.forename: L
authors.initials: L
authors.lastname: Heron
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged