SCREENING FOR PSYCHIATRIC COMORBIDITY AMONG FEMALE ALCOHOLICS: THE USE OF A QUESTIONNAIRE (SCL-90) AMONG WOMEN EARLY IN THEIR TREATMENT PROGRAMME

The use of a questionnaire, Symptom Check List-90 (SCL-90),as a screening instrument for psychiatric disorders was studiedin 60 women attending their first treatment for alcohol abusein Stockholm, Sweden. A global SCL-90 index, the General SymptomaticIndex (GSI), measuring the total level of recent self-reportedpsychological distress, showed a high efficacy in distinguishing‘psychiatric cases’ from ‘non-cases’in the present sample. Psychiatric cases were defined as subjectssatisfying the criteria for any current DSM-III-R disorder otherthan substance abuse. The psychiatric diagnoses were obtainedindependently by use of the Structured Clinical Interview forDSM-III-R (SCID-I). Psychiatric disorders, especially depressionand anxiety disorders, frequently antecede or develop secondaryto alcohol abuse among women. The use of structured interviewsto diagnose these disorders is, however, time-consuming. Findingsfrom the present study indicate that SCL-90 can be used to detectpsychiatric comorbidity among female alcoholics, thus enablingclinicians to be aware of concomitant psychiatric disordersamong a subgroup of patients.     

Early treatment of women with alcohol addiction (EWA): a comprehensive evaluation and outcome study. I. Patterns of psychiatric comorbidity at intake

This paper deals with psychiatric comorbidity among 60 women problem drinkers treated in a specialized women-only treatment programme (EWA) at Karolinska Hospital, Stockholm, Sweden. The programme attracts women who have not been previously treated for alcohol problems. The methods used were structured interviews (SCID-I and SCID-II) applied at least 10 days after the start of treatment. All but two of the women had a definite alcohol dependence according to the DSM-III-R, and a majority (60%) also fulfilled the criteria for at least one psychiatric disorder during their lifetime. However, only 23% had a personality disorder (PD), and all subjects with a PD also had at least one Axis I disorder. The most common disorders were mood disorders (48%) and anxiety disorders (38%). However, alcohol dependence developed without definite pre-existing psychiatric disorders among a substantial proportion of the women (40%). It remains to be seen whether and how psychiatric disturbances among female problem drinkers affect treatment compliance and long-term outcome.