Alcohol Dependence in Gastroenterology Outpatient on a Public Hospital

Abstract

-Background -Alcoholism and alcoholic liver disease are both considered worldwide health problems. Objective -The prevalence of alcohol dependence, the associated risk factors and the concordance between the prevalence found and the data collected during the medical visit were evaluated. Methods -A prospective study evaluating gastroenterology outpatients at a public tertiary hospital was conducted. Two specific questionnaires to assess alcohol dependence were applied: Cut down, Annoyed by criticism, Guilty, Eye-opener (CAGE) and The Alcohol Use Disorder Identification Test (AUDIT). Data on comorbidities, clinical diagnosis and assessment of alcohol consumption by the attending physician were collected through medical records. Results -One hundred and seventy eight patients were interviewed, of which 119 (66.9%) were women and 59 (33.1%) were men, with mean age of 57 years. Thirty-three (18.5%) of the 178 patients were considered alcohol-dependent by the CAGE questionnaire. Thirteen (7.3%) patients scored 8 points or more on the AUDIT questionnaire. The agreement (kappa) between these questionnaires was 0.37 (P<0.001). The most consumed drink was beer. The median daily consumption of dependent patients was 64 g. None of the patients were undergoing treatment in a specific treatment center, and 14/33 (42.4%) patients considered themselves alcoholics. Only in 17/33 (51.5%) there was information about alcoholism in their respective medical records. In the bivariate analysis, male gender (P<0.001), onset of alcohol consumption before the age of 15 (P=0.003), daily alcohol consumption in the last 12 months (P<0.001) and smoking (P<0.001) were identified as risk factors. After multivariate analysis, only male gender (P=0.009) and smoking (P=0.001) were associated with alcoholism. Conclusion -The present study demonstrated a high prevalence of alcohol dependence in the gastroenterology outpatient clinic, being predominantly associated with male gender and smoking. It is worth noting that approximately half of the dependents were not identified as such in the medical appointment, evidencing the importance of the diagnostic approach in the alcoholic outpatient.

Commonality of Ethanol and Nicotine Reinforcement and Relapse in Wistar‐Derived UChB Rats: Inhibition by N‐Acetylcysteine

“…DiFranza and Guerrera () reported that 83% of alcoholics are smokers compared to 34% of the nonalcoholic subjects. Smoking also was highly associated with alcoholism in an outpatient Gastroenterology Unit (Pranke and Coral, ). A biological predisposition is further seen in rats bred as high‐alcohol drinkers, which intravenously self‐administer nicotine at higher rates than nondrinker rats (Lê et al., ).…”