Alcohol-related disorders among medical and surgical in-patients in a Nigerian teaching hospital

Abstract

Alcohol use disorders exist in a high proportion of hospitalized patients and this often complicates patient management, but a large proportion of them still go unrecognized by the managing clinicians. The objective was to provide data on the proportion of inpatients 18 years and above with alcohol-related disorders, and ability of the managing clinicians to detect these disorders. Alcohol use disorders were assessed in 339 consecutive patients admitted into medical and surgical wards of University of Ilorin Teaching Hospital (UITH), Ilorin, using the Structured Clinical Interview for DSM-IV Disorders (SCID) -- Alcohol module, for a period of 5 months. They were also assessed for the presence or absence of alcohol-related problems (physical, psychological, and social) by direct questioning. In addition, patients' case notes were scrutinized for additional information on alcohol-related problems and ability of managing clinicians to detect alcohol-related problems in their patients. All patients with alcohol use disorders were males. The point prevalence for alcohol abuse and alcohol dependence using DSM-IV criteria were 16.4% and 8.5%, respectively among males while another 1.2% who did not meet DSM-IV criteria for abuse and dependence, had alcohol-related problems. Marital disharmony, financial problems, and deteriorating work performance were the most common psychosocial problems among the drinkers. Gastritis occurred in 18.5% of cases with alcohol abuse and 21.4% of cases with alcohol dependence. Other physical problems among drinkers included liver cirrhosis, malnutrition, and various injuries. Significantly more patients aged (45-64 years) and patients of low educational status compared to abstainers had alcohol use disorders and alcohol-related problems. In addition, significantly more patients with alcohol use disorders/alcohol-related problems compared to abstainers were observed to have physical and psychosocial health problems. Alcohol-related problems were detected in only 10.9% of the alcohol users by the managing clinicians. There is a considerable case load of patients with alcohol-related disorders in the hospital. There is therefore the need to improve ability of the managing clinicians to detect and manage cases of alcohol-related disorders, with referrals where appropriate.