The most important co-morbidities of alcoholism

Alcoholism is a very serious social, medical and psychological problem that affects both women and men. According to the World Health Organization (WHO), however, men are up to three times more likely than women to develop an addiction to alcohol.

Beyond the serious consequences of alcohol on our lives, minds and bodies, it is widely recognized that it has many co-morbidities.

In this article we will know the most frequent co-morbidities of alcoholismIn other words, the disorders and symptoms that are usually associated with it, according to data from DSM-5 and also from various scientific studies.

    Co-morbidities of alcoholism

    Before we explore what co-morbidities in alcoholism are, let’s clarify the concept of co-morbidity. Comorbidity is a term coined in 1970 by clinician and researcher Alvan.R. Feinstein. This concept refers to the presence of one or more disorders, in addition to the primary underlying disorder (we also refer to diseases).

    In the case of alcoholism, there are multiple comorbidities to this disorder, both psychopathological (mental disorders) and medical (diseases themselves). In addition, both medically and psychologically, the co-morbidities of alcoholism have been a topic of interest that has grown steadily over the years.

    In clinical practice, we observe that it is more and more difficult to find “pure” cases of alcoholism., Because most of them are already accompanied by one or more associated disorders.

    It should be noted, moreover, that the field of addictions is very frequent in patients of the so-called polydependence (addiction in addition to a substance) (without forgetting the psychopathological disorders of an emotional and affective nature added and medical diseases. ).

      Commonly Associated Alcoholism Disorders: DSM-5

      In the DSM-5 (Diagnostic Manual of Mental Disorders), alcoholic disorder is associated with other psychiatric disorders. This means that just because you are suffering from alcoholism, there is also an additional risk of suffering from this type of disorder (At the onset of the addictive disorder or even over time). These disorders and / or symptoms are:

      • Dependence on and abuse of other substances, such as: sedatives, hypnotics, cannabis, cocaine, heroin, anxiolytics and amphetamines
      • schizophrenia
      • depression

      • anxiety
      • insomnia
      • Increased risk of: accidents, violence and suicide
      • Personality disorders: especially antisocial (increased likelihood of committing criminal acts)

      • Social problems (for example breaking up or uprooting of the family)

      studies

      We have seen what the DSM-5 says about frequent co-morbidities of alcoholism, but what does the scientific literature say?

      1. Psychopathological symptoms

      To talk about the comorbidities of alcoholism with regard to psychopathological symptomatology, we will refer to the results of a study carried out in 2006 (Landa, Fernández-Montalvo, López-Goñi and Lorea). This study shows how the main disorders and / or symptoms associated with alcoholism, at the psychopathological level, are anxiety-depressive in nature.

      These symptoms are more observed in alcoholism than in the general population (without alcoholism). Also, it should be noted that the frequency and intensity of these symptoms are related to the severity of alcohol dependence.

      This results in more severe associated symptoms in patients with more severe alcoholism. This comorbidity must be taken into account in terms of treatment and possible risk of relapse..

      2. Pathological gambling

      Another of the frequently observed co-morbidities of alcoholism is pathological gambling. Specifically, a 2005 study, developed by Fernández-Montalvo, indicates that 20% of alcoholic patients in the sample also have an associated (comorbid) diagnosis of pathological gambling (Ludopathy).

      On the other hand, according to the aforementioned study, 12% of the patients in the sample also presented symptoms that could indicate a possible diagnosis of gambling disorder, without however meeting the diagnostic criteria.

      In addition, it has been observed that the severity of gambling symptoms was linked to a more serious drinking problem.

        3. Personality disorders

        Personality disorders are another of the frequently observed co-morbidities of alcoholism (particularly antisocial personality disorder, as we have already seen in section DSM-5).

        Numerous studies have also been carried out on this subject; in this article we have selected two: the first, prepared in 2002 by Fernández-Montalvo, Landa, López-Goñi, Lorea and Zarzuela, and the second a little later, in 2006, by Fernández-Montalvo, Landa, López – Goñi and Lorea.

        According to the results of these studies, co-morbidity between alcoholism and certain types of personality disorders is between 22 and 64% of cases, Which is quite alarming.

        Three major groups of alcoholism

        Another 2001 study, developed by Valbuena et al., Found different types of alcohol consumption with models well differentiated:

        • Patients who have suffered from alcohol poisoning
        • High risk patients
        • Patients with alcohol dependence

        It should be noted that these groups are not categorically independent, but several of its symptoms or consequences overlap. Additionally, people in each group can move to another over time, and / or revert to the original group, and so on.

        But let’s get to the important thing; What was observed in each group for co-morbidity associated with alcoholism? Let’s see:

        1. Alcohol poisoning group

        We noticed that in this first group (it was a young group), they existed associated transient emotional disturbances, but without somatic or psychiatric repercussions.

        2. High risk consumer group

        In the second group, the high-risk drinking group (which includes harmful or abusive consumption of alcohol and other substances), great social and family instability was noted, as well as serious comorbid psychiatric disorders.

        3. Group with alcohol dependence

        In the group with alcohol dependence (middle age) they were found to be severe organic and cerebral sequelae, added to a strong tendency to isolation and depressive symptoms.

        Medical and organic problems and life expectancy

        Beyond the many co-morbidities of alcoholism mentioned, we must not forget its repercussions and consequences at the organic level, because alcohol is a drug very harmful to health, which major problems with the liver, pancreas, heart, sexual dysfunction, etc.

        All this without mentioning the serious social, personal and professional consequences resulting from its consumption.

        On the other hand, referring to a study carried out by two German universities, that of Greifswald and that of Lübech, he reveals that the life expectancy of alcoholics is reduced, on average, by 20 years compared to the normal population (non-alcoholic). Once again, an alarming fact.

        Bibliographical references:

        • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
        • Landa, N., Fernández-Montalvo, López-Goñi, J. Lorea, I. (2006). Psychopathological comorbidity in alcoholism: a descriptive study. International Journal of Clinical and Health Psychology, 6 (2), 253-269.
        • Valbuena, A., Largo, R., Quintero-Gutiérrez, J., García-Resa, I., and Correas, J. (2001). Comorbidity in admitted alcoholics. Clinical and socio-health implications. Addictions, 13 (3): 297-304.

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