Psychiatric Illness and Alcoholism

Abstract

City is presently engaged in a systematic diagnostic study of male admissions to the psychiatric inpatient service. Data are gathered by means of a structured psychiatric interview, which primarily reflects the diagnostic criteria for use in psychiatric research developed at Washington University. The present report describes the preliminary diagnostic findings from the first 120 subjects regarding differences between alcoholic and nonalcoholic inpatients. METHODA structured psychiatric interview, developed and tested by Twang,' was expanded for the present study to collect not only information relevant to the Washington University Diagnostic Criteria, but also other data possibly relevant to psychiatric illness.All psychiatric inpatient admissions were eligible for the study except: (I) female patients, (2) patients 65 and over, and/or (3) patients remaining on the inpatient service for fewer than four days. Patients meeting selection requirements were approached on the fourth hospital day, informed of the study, and, following signed consent. were administered the structured psychiatric interview by a trained technician. In the few cases in which subjects were too agitated to participate, the interview was postponed.Following data collection, the completed interview, without information identifying the subject, was given to two psychiatrists unaware of one another's psychiatric assessment. The psychiatrists made psychiatric diagnoses according to the Washington University Diagnostic Criteria' up to a maximum of three for any subject. Folkwing both diag-

Co-occurring disorders among mentally ill jail detainees: Implications for public policy.

“…The rate ofcodisorders among our sample of severely ill jail detainees was also considerably higher than rates found in patient populations. Studies of emergency room patients (E. Robins, Gentry, Munoz, & Marten, 1977) and psychiatric inpatients (Bernadt & Murray, 1986;Crowley, Chesluk, Dilts, & Hart, 1974;Fowler, Liskow, Tanna, & Van Valkenburg, 1977;Wolf et al, 1988) have found that schizophrenics were less likely than other diagnostic groups to have substance abuse disorders; one investigator found schizophrenia to be virtually diagnostically "uncontaminated" (E. Robins et al, 1977, p. 263). Studies of inpatients with affective disorders also found fewer co-occurring substance abuse disorders than among other diagnostic groups (Fowler et al, 1977;Wolf et al, 1988; in contrast, see Bernadt & Murray, 1986).…”

“…Studies of emergency room patients (E. Robins, Gentry, Munoz, & Marten, 1977) and psychiatric inpatients (Bernadt & Murray, 1986;Crowley, Chesluk, Dilts, & Hart, 1974;Fowler, Liskow, Tanna, & Van Valkenburg, 1977;Wolf et al, 1988) have found that schizophrenics were less likely than other diagnostic groups to have substance abuse disorders; one investigator found schizophrenia to be virtually diagnostically "uncontaminated" (E. Robins et al, 1977, p. 263). Studies of inpatients with affective disorders also found fewer co-occurring substance abuse disorders than among other diagnostic groups (Fowler et al, 1977;Wolf et al, 1988; in contrast, see Bernadt & Murray, 1986). Researchers in Veterans Administration (VA) hospitals (which, like jails, have largely male populations) found rates of co-occurring disorders substantially below our jail rates, at least for schizophrenics.…”

Screening medical patients for alcoholism with the MMPI: A comparison of seven scales

“…A comparable study among medical patients (Swenson & Morse, 1975) suggested that prevalence rates of approximately 16% for men and 6% for women should be expected in the target population of medical patients to be screened. Unfortunately, although studies have been undertaken, base rates for male psychiatric patients (Fowler, Liskow, Tanna, & Van Valkenburg, 1977;O'Farrell et al, 1983; Simon et al, 1968; Whittier & Korenyi, 1961) have not been well established, and prevalence rates for alcoholism among female psychiatric patients are unknown.…”

Resurrecting the ICAS: A competitor for the MAC in screening medical patients for alcoholism?

“…Furthermore, the proportions of alcoholic men identified by the ICAS in the medical and normal samples are generally consistent with lifetime prevalence rates, a substantial improvement over the inflated proportions classified as alcoholic by the MAC scale. However, a large number of male psychiatric inpatients (46%) were identified by the ICAS as alcoholic, although the base rates for male psychiatric patients have not been well established (Fowler, Liskow, Tanna, & Van Valkenburg, 1977;O'Farrell, Connors, & Upper, 1983;Simon, Epstein, & Reynolds, 1968;Whittier & Korenyi, 1961). A base rate of 20% among psychiatric patients has been experienced in our setting.…”