Alcohol addiction treatment, comorbidity and after-care in 12 short residential programs during 2009 in Italy: Ina Maria Hinnenthal

Issue

Alcoholism is in Italy a central social and sanitary problem with a consequent rapid growth of short residential treatment facilities (1-6 months) during the last 20 years. Recently 12 of them joined together trying to understand their own work better. Description of the problem: This study included 2061 patients discharged during 2009 from the 12 involved structures. The case-manager had to compile a 26 items schedule for any patient regarding socio-demographic, clinical and diagnostic aspects and planned after-care (for 5 patients the data was not complete).

Results

The mean age (±Standard Deviation) was 46.3 (± 10.8) years, and 1411 (68.6%) patients were males. The mean duration of hospitalization was 29.5 (±23.5) days. 934 patients (45.3%) had a comorbidity with one or more organic diagnosis, 12.5% of them had a cirrhosis, 6.6% had a polyneuropathy syndrome. Among the 1327 patients with a dual diagnosis (psychiatric disorder and/or abuse/dependency of other substances) 44% was affected by a second abuse or dependency of illegal substances or drugs and 41% were affected by a personality disorders. The proportion of males in patients affected by a dual diagnosis was significantly lower than in patients without (p < 0,0001, 65,0% vs 75,2%). The patients affected by dual diagnosis were significantly younger (p < 0,001, 44.5 vs 49.5 years), had a higher degree of education (p < 0,0003 42.1% vs 34.1% was graduated or finished at least high-school), had more frequently been hospitalized for alcohol correlated reasons (p < 0,0001, 48.4% vs 33.4%), came less often from the public addiction ambulatories (p < 0,0001, 53.9% vs 64.0%%). The 1166 patients without previous hospitalization had a follow-up using a short telephone interview: The patients with psychiatric co-morbidity had the same probability to remain sober after 6 months as the others (p < 0,9738, 79.4% vs 79.3%), this was true also after 12 months (p < 0,2399, 78.5% vs 81.8%).

Thanks to: G. Corrao, Dipartimento di Statistica e Metodi Quantitativi, Università degli Studi Milano Bicocca, Milano, Italy

Key messages

• Younger Patients with alcohol problems in short residential programs in Italy are more often affected by a dual diagnosis and/or other drug dependencies without worse follow-up results.

• There has been a shift in the phenomenon of alcoholism that makes treatments more difficult, but worthwhile. Early diagnosis and new specialized programs are fundamental.