Frequency of alcohol use disorders in patients admitted in a psychiatric hospital according to admission diagnosis

Abstract

Background: Comorbidities such as mental illness and alcohol use disorders (AUD) worsen the prognosis of both conditions. There is a need to identify early alcohol use disorders in psychiatric patients to prevent the development of dual diagnosis diseases, which are more difficult to treat. The Alcohol Use Disorders Identification Test (AUDIT) was developed by the World Health Organisation to promote early identification of alcohol use disorders and has been validated mainly in primary care settings. No study has validated the AUDIT in a French-speaking psychiatric setting. There is also a need to identify the risk factors of heavy drinking with psychiatric disorders. Purpose: This study aims at (1) validating the French version of the Alcohol Use Disorders Identification Test (AUDIT) for psychiatric inpatients and (2) determining the frequency of alcohol use disorders in four major psychiatric ICD-10 diagnostic categories: neurotic and depressive disorders (F3 and F4), personality disorders (F6), psychotic disorders (F2) and other disorders (n = 10). Subjects and methods: Of 383 consecutive psychiatric admissions, 219 completed the AUDIT. A subset was also interviewed with the CIDI (gold standard) and was retested with the AUDIT. Psychiatric diagnoses were recorded from hospital medical records. Results: Validation of the AUDIT showed a very good sensitivity (94.1%) and specificity (91.7%) in this psychiatric inpatient population. Frequency of alcohol use disorders was 35.1%. Personality disorders had the highest rate of AUDIT scores ≥8 (50.7%). Gender was the only statistically significant outcome in a multivariate model. Discussion: Male sex as an outcome associated with the presence of alcohol use disorders, is consistent with the other AUDIT studies in psychiatry. The uniqueness of the present study is the evaluation of personality disorders among the psychiatric diagnostic categories. Conclusion: This study strengthens the evidence that the AUDIT is reliable and valid with psychiatric patients and confirms the high frequency of alcohol use disorders in this population. Drinking habits of patients with emotionally labile personality disorders should be screened.