Alcohol-related disorders among medical and surgical in-patients in a Nigerian teaching hospital

Background/Objectives: Alcohol use disorders exist in a high proportion of hospitalized patients and this often complicates patient management, but a large proportion of them still go unrecognized by the managing clinicians. The objective was to provide data on the proportion of inpatients 18 years and above with alcohol-related disorders, and ability of the managing clinicians to detect these disorders. Materials and Methods: Alcohol use disorders were assessed in 339 consecutive patients admitted into medical and surgical wards of University of Ilorin Teaching Hospital (UITH), Ilorin, using the Structured Clinical Interview for DSM-IV Disorders (SCID) -- Alcohol module, for a period of 5 months. They were also assessed for the presence or absence of alcohol-related problems (physical, psychological, and social) by direct questioning. In addition, patients′ case notes were scrutinized for additional information on alcohol-related problems and ability of managing clinicians to detect alcohol-related problems in their patients. Results: All patients with alcohol use disorders were males. The point prevalence for alcohol abuse and alcohol dependence using DSM-IV criteria were 16.4% and 8.5%, respectively among males while another 1.2% who did not meet DSM-IV criteria for abuse and dependence, had alcohol-related problems. Marital disharmony, financial problems, and deteriorating work performance were the most common psychosocial problems among the drinkers. Gastritis occurred in 18.5% of cases with alcohol abuse and 21.4% of cases with alcohol dependence. Other physical problems among drinkers included liver cirrhosis, malnutrition, and various injuries. Significantly more patients aged (45-64 years) and patients of low educational status compared to abstainers had alcohol use disorders and alcohol-related problems. In addition, significantly more patients with alcohol use disorders/alcohol-related problems compared to abstainers were observed to have physical and psychosocial health problems. Alcohol-related problems were detected in only 10.9% of the alcohol users by the managing clinicians. Conclusion: There is a considerable case load of patients with alcohol-related disorders in the hospital. There is therefore the need to improve ability of the managing clinicians to detect and manage cases of alcohol-related disorders, with referrals where appropriate.