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        이중진단을 가진 알코올 의존 환자들의 임상적 특성(II)

        성상경(Sang-Kyung Sung):문석우(Seok-Woo Moon):강지언(Gi-Eun Kang),이규항(Kyu-Hang Lee) 한국중독정신의학회 2001 중독정신의학 Vol.5 No.1

        Objectives:Abuse of alcohol or drugs can induce, or can result from psychiatric disorders. Any substance of habituation has psychotoxicity and can induce psychiatric symptoms. These symptoms usually disappear after the effect of the substance terminates, but the symptoms can be continued permanently. It is well known that depression, anxiety disorder, and personality disorder very often come together with the alcohol dependence. Therefore, we have selected groups having extra-psychopathology from alcohol dependence patients, and compared their clinical characteristics with patients of alcohol dependence only, to use the characteristics in the therapy. Methods:Among patients hospitalized in a mental hospital from Feb.-June of 1999 for the problem of alcohol dependence, patients diagnosed as alcohol abuse/dependence and dual diagnosis by DSM-Ⅳ were evaluated by the methods of chart review, the questionnaire of demographic characteristics, drinking history, past therapy history, family history, NAST and CAGE. Results:1)Among 179 patients diagnosed to be alcohol dependent during the period, 59 patients (33%) were dually diagnosed and their average age was 42.5±8.5, and 120 patients (67%) were diagnosed to be alcohol dependence only and their average age was 45.6±9.6. In the case of dual diagnosis, the average age diagnosed as alcohol dependence was earlier. The men/women ratio was 169 men:10 women (94.4%:5.5%). Age of first drinking was 20.3 in dually diagnosed patients and 21.2 in alcohol dependence only patients. Therefore, they started drinking in early 20s in both cases. 2) There were notable differences between them in drinking amount, self- recognition of dependence, the number of suicide attempts. 3) There were no statistical significances between them in age of first drinking, drinking period, age of withdrawal symptom experience, preference of alcohol beverage, therapy history, and demographic characteristics except age and gender Though there was no statistical significance in NAST score and the total number of questions of NAST and CAGE, the score and the total number in dual diagnosis were higher than the alcohol dependence only. This result indicates that the dually diagnosed patients recognize symptoms more seriously, and they are high risk group. Conclusions:The dually diagnosed patients among alcohol dependent patients showed higher level of self-recognition, higher score of NAST and CAGE, more number of therapy (recurrence), earlier onset age of alcohol dependence, less average drinking amount, and more suicide attempts. It is therefore believed that the dually diagnosed patients are higher risk group compared to the patients of alcohol dependence only, and it is required to do intensive evaluation and carefully designed therapy.

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