Assessment of axis I and axis II comorbidities in hospitalized patients with alcohol dependence [Alkol bag˜imlilig˜i olan yatan hastalarda eksen I ve eksen II eştanilarinin deg˜erlendirilmesi]
Objective: Higher comorbidity rate with anxiety, depression and personality disorders have been consistently reported for patients with alcohol dependence. Presence of a comorbid disorder might result in poorer disease course and affect the treatment and prognosis. The aim of present study was to determine the prevalence of axis I and axis II comorbidities in hospitalized patients with a diagnosis of alcohol dependence and assess the influence of comorbidity on disease and sociodemographic characteristics of the patients. Methods: Eighty patients (72 male, 8 female) diagnosed as alcohol dependence according to DSM-III-R and age range between 24 and 57 were included in this study. Patients were first interviewed within 4th to 6th week after the completion of withdrawal treatment for alcohol. Sociodemographic form and Structured Clinical Interview for DSM-III-R for both axis I and axis 11 disorders have been completer. Along with these instruments, all patients filled Symptom Check List, Spielberger's State and Trait Anxiety Inventory, Beck Depression Inventory for objective evaluation of depression and anxiety symptoms. Results: Sixty five percent of all cases had at least one comorbid axis I disorder according to DSM-III-R. Most common axis I comorbid disorder was major depression. 72.5% of cases had at least one comorbid personality disorder. B cluster personality disorder was the most common comorbid personality cluster. Antisocial and borderline personality disorders were the most frequent comorbid personality disorders respectively. Fifthy percent of cases had both axis I and axis II comorbid diagnoses. 10 (12.5%) cases did not have any comorbid disorders in both axes. Patients with a diagnosis in axis II had significantly higher additional substance abuse, suicide attempt and earlier onset for using alcohol. Conclusions: Presence or comorbid axis I and axis II disorders like anxiety, depression and personality disorders have clear impacts on treatment and prognosis of patients with a diagnosis of alcohol dependence. Thus, the detailed evaluation of presence of comorbidity by clinicians will provide significant contributions to management, diagnosis and treatment of cases with alcohol dependence
