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  • 1
    Electronic Resource
    Electronic Resource
    Factors influencing remission from alcohol dependence without formal help in a representative population sample (2001)
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 96 (2001), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: 
 Aims. To analyse factors related to remission without formal help by using a representative sample and standardized instruments. 
Design. Two groups of untreated alcohol-dependent subjects were compared. 
Setting. General population survey. 
Participants. Thirty-two subjects fully remitted without formal help (NFH) and 26 current alcohol-dependent individuals (CAD) according to DSM-IV drawn from a representative general population sample in northern Germany (response rate: 70.2%, n = 4075). 
Measurements. Data focusing on the 2 years prior to remission from NFH were compared with past-year data from CAD. Groups were compared on variables found to be associated with remission without formal help in previous research. 
Findings. Logistic regression analysis revealed that individuals remitted from alcohol-dependence without formal help reported a higher non-physiological severity of alcohol dependence, less social pressure to quit drinking and more incidents of driving while intoxicated. Furthermore, they tended to report more satisfaction with work and financial situation and were more likely to live in a stable partnership. 
Conclusions. Findings support the concept of psychosocial resources as important enabling factors in remission from alcohol dependence without formal help. Implications for brief interventions are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.969132712.x
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  • 2
    Electronic Resource
    Electronic Resource
    Studies on natural recovery from alcohol dependence: sample selection bias by media solicitation? (2000)
    Oxford, UK : Carfax Publishing, Taylor & Francis Ltd
    Addiction 95 (2000), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Abstract Aims. To assess the selection bias of recruiting participants in studies on natural recovery from alcohol dependence through media solicitation. Design. Two samples with different recruitment strategies are compared. Setting. Media solicitation and general population. Participants. Sample 1 consists of 176 alcohol-dependent individuals remitted without formal help and recruited through media solicatation, sample 2 consists of 32 natural remitters derived from a representative general population study with a sample size of 4075 respondents and a response rate of 70.2%. Measurements. Several triggering mechanisms and maintenance factors of remission were assessed in a personal interview using standardized questionnaires. Findings. Results of logistic regression analyses show that media-solicited subjects were more often abstinent in the last 12 months, were more severely dependent, were less satisfied with eight life domains prior to remission and showed higher scores in a coping behaviour measure. Besides these major differences from the multivariate analysis, media subjects revealed more health problems prior to remission, experienced more social pressure to change drinking behaviour, and showed differences in reasons for not seeking help. Conclusions. Media solicitation leads to a sample selection bias in research on natural recovery from alcohol dependence. When measures to foster self-change are derived from such studies, findings from representative samples have to be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2000.95576512.x
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  • 3
    Electronic Resource
    Electronic Resource
    Differences between hospital patients with alcohol problems referred for counselling by physicians' routine clinical practice versus screening questionnaires (1998)
    Oxford, UK : Carfax Publishing Limited
    Addiction 93 (1998), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. To test the hypothesis that screening for alcohol-related disorders in a general hospital with questionnaires generates a target group of patients for alcohol counselling which differs from patients referred by physicians' routine clinical practice. Design. A prospective study with follow-up after 12 months. Setting. Medical and surgical wards of a general hospital. Participants. A sample of 298 patients detected by screening questionnaires (CAGE, MAST) was compared with a sample of 87 patients referred by physicians. Measurements. The main measurements were a diagnostic interview (SCAN), two questionnaires to estimate the severity of dependence and the motivation to change drinking behaviour (RCQ, LAS), and socio-demographic variables. Outcome criteria were utilization of remedial programmes, decreases in hazardous and excessive drinking and abstinence rates. Findings and conclusions. Patients referred by physicians were more often separated and unemployed, were more likely to be alcohol-dependent and to be more severely dependent, had a higher rate of alcohol-related diseases as reasons for admission, were more often motivated to change drinking behaviour, had a higher participation rate in remedial programmes and more often exhibited improvements in drinking behaviour compared with the sample identified by screening questionnaires. However, there was evidence of improvements in drinking in both samples. Data show that while screening reaches a less problematic sample with lower motivation to change, it is a worthwhile activity which extends the spectrum of patients eligible for brief interventions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1998.931217774.x
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  • 4
    Electronic Resource
    Electronic Resource
    Influence of psychiatric comorbidity in alcohol-dependent subjects in a representative population survey on treatment utilization and natural recovery (2005)
    Oxford, UK : Blackwell Science Ltd
    Addiction 100 (2005), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Background  It is well known that only a minority of alcohol-dependent subjects seek help and that the majority of alcohol-dependent individuals recover without utilization of formal help. Psychiatric comorbidity is highly prevalent among alcohol-dependent individuals. However, no data are available on the impact of psychiatric comorbidity on natural recovery.Aims  To analyse the impact of non-psychotic psychiatric comorbid Axis I disorders on remission rate and utilization of formal help in alcohol-dependent individuals drawn from a representative general population sample in northern Germany (response rate: 70.2%, n = 4075). Psychiatric diagnoses and utilization of help were assessed in a personal interview using standardized instruments. One hundred and fifty-three life-time alcohol-dependent individuals were assessed, among whom 98 fulfilled the criteria for sustained long-term remission according to the Diagnostic and Statistical Manual version II (DSM-IV) criteria. Any coincidence of DSM-IV non-psychotic Axis I disorders with alcohol dependence was counted as comorbidity. Comorbidity rate in the whole sample was 36.1%.Results  The rate of individuals who remitted from alcohol dependence without formal help was 36.9% in the non-comorbid and 42.6% in the comorbid group. Utilization of formal help was unrelated to comorbidity. Dually diagnosed subjects without a history of help-seeking showed minor differences concerning reasons for not seeking help. Seeking help was not related to schooling, severity of dependence and gender.Conclusion  Data reveal that remission without formal help is equally prevalent among non-comorbid as among comorbid alcohol-dependent individuals. Axis I comorbidity is not related directly to utilization of alcohol-related help. Negative prognoses for untreated comorbid alcohol-dependent individuals are not justified from an epidemiological point of view.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.2005.01008.x
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  • 5
    Electronic Resource
    Electronic Resource
    Types of natural recovery from alcohol dependence: a cluster analytic approach (2003)
    Oxford, UK : Blackwell Science Ltd
    Addiction 98 (2003), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Background  Social capital and a low severity of alcohol-related problems have been focused upon to explain the processes of natural recovery from alcohol dependence. However, studies using control groups have not found significant differences in these variables. Subtypes of natural remission which might account for this inconsistency have only been described on grounds of qualitative data.Aims  To identify subtypes of natural remitters using cluster analysis.Participants  One hundred and seventy-eight media-recruited natural remitters were interviewed personally. Several triggering mechanisms and maintenance factors of remission were assessed using standardized questionnaires. Based on age of onset and severity of dependence, adverse consequences from drinking, social pressure and social support, cluster analyses were performed.Results  Cluster analyses yielded three groups of natural remitters: one cluster with a high severity of dependence, low alcohol-related problems and low social support (‘low problems—low support’; n = 65), one group characterized by high severity of dependence, high alcohol-related problems and medium social support (‘high problems—medium support’; n = 37), and a third group which consisted of subjects with high social support, late age of onset, low severity of dependence, and low alcohol-related problems (‘low problems—high support’; n = 76). Cluster solutions were confirmed using discriminant analyses. Analyses of variance (ANOVAs) revealed further group differences on other triggering and maintaining factors of remission.Conclusions  Failure to identify specific pointers to natural recovery in previous research might be due to heterogeneous subgroups of natural remitters. In order to build a conceptual framework for understanding the processes of natural recovery, interactions of different independent variables should be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.2003.00571.x
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  • 6
    Electronic Resource
    Electronic Resource
    Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study (2000)
    Springer
    Social psychiatry and psychiatric epidemiology 35 (2000), S. 539-547 
    Details
    ISSN: 1433-9285
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Background: The aim of the Transitions in Alcohol Consumption and Smoking (TACOS) project is to investigate substance use and use disorders in the adult general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitudinal project are described. Prevalence rates of alcohol use disorders, consumption pattern, and the nature of their association are also analysed with regard to preventive strategies. Method: A random sample of 4075 participants, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an unbiased database with regard to demographic characteristics. Results: Low lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to southern regions of Germany and US American data. In contrast, we found a comparatively high percentage of moderate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3–13.2; dependence OR 4.3, 95% CI 2.8–6.4). The association between alcohol use disorders and alcohol consumption pattern revealed a weaker relation for alcohol abuse compared to dependence. Conclusion: National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001270050277
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  • 7
    Electronic Resource
    Electronic Resource
    Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany (2000)
    Springer
    European archives of psychiatry and clinical neuroscience 250 (2000), S. 262-268 
    Details
    ISSN: 1433-8491
    Keywords: Key words Obsessive-compulsive disorder ; Subclinical OCD ; Epidemiology ; Quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. Methods: German versions of the DMS-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18–64 years living in a northern Germany region. Specific DSM-IV based criteria for subclinical OCD were used. Results: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. Conclusion: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004060070017
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  • 8
    Electronic Resource
    Electronic Resource
    Lebenszeitprävalenz psychischer Störungen in der erwachsenen Allgemeinbevölkerung Ergebnisse der TACOS-Studie (2000)
    Springer
    Der Nervenarzt 71 (2000), S. 535-542 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychische Störungen ; Epidemiologie ; Erwachsene Allgemeinbevölkerung ; Prävalenz ; Standardisierte Diagnostik ; Key words Psychiatric disorders ; Epidemiology ; Adult general population ; Prevalence ; Standardized diagnostic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The present paper reports lifetime prevalence rates of mental disorders in the 18- to 64-year-old general population of a northern German region. A representative random sample from registration office files of 4,075 individuals was examined in personal interviews using the fully standardized and computerised “Munich Composite International Diagnostic Interview” (M-CIDI). The response rate was 70.2%. Individuals were classified according to the DSM-IV. Substance use disorders were most frequent with 25.8% followed by anxiety (15.1%), somatoform (12.9%), affective (12.3%), and eating disorders (0.7%). Disorders other than substance use were more frequent in women and less frequent in men. A trend toward less psychiatric morbidity exists in individuals with higher educational level, higher income, and those who are married or reside in rural communities. Of all individuals affected by mental disorders, 42% fulfilled the criteria for at least one additional disorder. The results are discussed against the background of selected previous studies.
    Notes: Zusammenfassung Im vorliegenden Beitrag werden Ergebnisse zur Lebenszeitprävalenz psychischer Störungen in der 18- bis 64-jährigen Allgemeinbevölkerung einer norddeutschen Region berichtet. 4.075 Personen einer zu 70,2% ausgeschöpften repräsentativen Einwohnermeldeamtsstichprobe wurden mit dem vollstandardisierten und computerisierten “Münchener Composite International Diagnostic Interview” (M-CIDI) in persönlichen Interviews untersucht. Die hier berichtete Klassifikation erfolgte auf Grundlage des DSM-IV. Störungen durch den Konsum psychotroper Substanzen stellten mit einer Lebenszeitprävalenz von 25,8% die häufigste Diagnosengruppe dar, gefolgt von Angststörungen (15,1%), somatoformen Störungen (12,9%), affektiven Störungen (12,3%) und Essstörungen (0,7%). Frauen waren dabei häufiger von nicht-substanzbezogenen psychischen Störungen betroffen und Männer häufiger von Substanzmissbrauch und -abhängigkeit. Es zeigt sich ein Trend zu geringerer psychiatrischer Morbidität bei Individuen mit höherer Schulbildung, höherem Einkommen, verheirateten Personen und Personen mit ländlichem Wohnsitz. 42% der Probanden mit einer Lebenszeitdiagnose erfüllten die Kriterien mindestens einer weiteren Störung. Die Ergebnisse werden im Kontext ausgewählter bisheriger Studien diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050623
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