Author/Editor		Židanik, Miloš
Title		Analiza dispanzerske obravnave škodljivega uživanja lakoholnih pijač in odvisnosti od alkohola
Translated title		The management of harmful drinking and acohol dependence in ambulatory care
Type		članek
Source		Odvisnosti
Vol. and No.		Letnik 5, št. 3-4
Publication year		2004
Volume		str. 43-5
Language		slo
Abstract		Background. The aim of this article is the analysis of patients with alcohol-related disorders that were send in ambulatory care unit to verify the characteristics of the population and their treatment choice. Methods. The data from all patients with alcohol-related problems were analysed and followed up from 12 - 30 months. For the diagnostics ICD-10 and DSM-IV criteria were used. The level of cognitive functioning was established clinically. Results. There were 189 patients with alcohol-related problems, 7,5% of all patients that made an appointment in psychiatric ambulatory care. Among them were 154 male (81,5%) and 35 women (18,5%). The mean age of man was 44,6 ± 10,5 years and women 47,5 ± 11,5 years. The difference was significant (p<0,01). Patients from the sample had significant lower education level compared with the general population (p <0,003). 58,2 % of patients had dual or multiple diagnosis. Most common were depression (26,5%) and personality disorders (29,1%) The sub sample of women was at higher risk: women came later to the psychiatrist and had a higher proportion of depression (37,1% against 24% at man, p=0,0000). The most common motive for the medical visit was the necessity of evaluation of invalidity (20,6%). At 25,1% of the patients a lower cognitive level functioning was established. 10% came to the appointment under the influence of alcohol. The majority came in the practice only once or twice: 63,5% of patients from the sample. The drop-out between the 2.nd and 6.th month was 40,6% and from the 7.th to 12.th month 26,8%. After the first year only 15,9% were still in the treatment. Only 7,9% of the sample took part in a group therapy, which is the first choice treatment for alcoholics. (Abstract truncated at 2000 characters)
Summary		Izhodišča. Namen prispevka je analiza bolnikov, ki so usmerjeni v ambulantno obravnavo škodljivega uživanja in odvisnosti od alkohola in s tem določiti značilnosti te populacije tern jihovo odločanje za intenzivnejšo obravnavo. Metode. V raziskavo so bili zajeti vsi bolniki (n=189), ki so se zaradi težav, povezanih zaradi uživanja alkoholnih pijač, oglasili v našem Dispanzerju v obdobju dveh let. Rezultati. Bolniki v vzorcu so statistično značilno, dosegli nižjo izobrazbo kot Ijudje iz splošne populacije, med njimi je visok delež Ijudi z osebnostno motnjo (29,1 %). Najpogostejši vzrok prihoda je bila potreba po mnenju za Invalidsko komisijo (20,6%). 25,1 % jih je po grobi klinični oceni funkcioniralo na nižjem kognitivnem nivoju. Podskupina žensk je predstavljala skupino s še posebej izrazitim tveganjem: ženske so prihajale v psihiatrično obravnavo v značilno starejšem življenjskem obdobju kot moški in delež depresije je bil pri njih višji (37,1 % proti 24% pri moških). Samo enkrat in na največ enem kontrolnem pregledu se je oglasila večina: 63,5% bolniko v vzorcu. Med drugim in šestim mesecem je bil osip nadaljnih 40,6% preostale populacije in sedmim in dvanajstim letom 26,8%.Tako je bilo po prvem letu v obravnavi le še 15,9% prvotnega vzorca. 7,9% prvotnega vzorca se je odločila za skupinsko obravnavo odvisnosti, ki velja za terapijo prvega izbora. Zaključki. Glede na veliko rizičnost omenjene populacije z visoko smrtnostjo in komorbidnostjo, je potrebno povečati sodelovanje z zdravniki splošne medicine za uspešnejše zajemanje in usmerjanje Ijudi s težavami zaradi uživanja alkoholnih pijač v nadaljnjo obravnavo škodljivega uživanja ali odvisnosti od alkohola.
Descriptors		ALCOHOLISM AMBULATORY CARE COMORBIDITY MENTAL DISORDERS SOCIOECONOMIC FACTORS