원장님 논문1-이중진단환자들의 임상적 특성 1 > 자료실

이중진단환자들의 임상적 특성에 관한 비교연구(Ⅰ) - 일 병원 입원한 알코올의존 환자 및 정신질환자를 중심으로 -

계요의료재단 계요병원
성상경; 신범식; 강지언; 이규항;

The Comparison of the Clinical Characteristics in Hospitalized - Dual Diagnosed Alcoholics and Mentally Ill Patients (Ⅰ) -

Sang-Kyung Sung, MD; Bum-Shik Shin, MD; Gi-Eun Kang, MD; and Kyu-Hang Lee, MD;
Keyo Medical Foundation Keyo Hospital, Uiwang, Korea


Objectives：This study was carried out to compare the clinical characteristics between Primary Psychiatric disorder and Secondary Alcohol dependence (hereinafter PPSA) group and Primary Alcohol dependence and Secondary Psychiatric disorder (hereinafter PASP) group. So authors aimed to establish the therapeutic plan and method of approach for dual diagnosed patients through understanding the differences of the clinical characteristics between two groups.

Methods：The subject consist of 128 male and female inpatients who met dual diagnosis of alcoholism and other mental disorders consecutively admitted to this mental hospital from February 1, 1999 to June 30, 1999. The questionnaires which include sociodemographic data, past alcohol history, family loading etc. Also the subjects were screened by NAST (National Alcoholism Screen Test) and CAGE scales. A dual diagnosis were made by charge doctors and chart review including past alcohol history.

Results：1) There were no differences in demographic characteristics between two groups but over the half of them were lower socioeconomic status. 2) PPSA group had a preference for low degree alcoholic beverage, less recognized their addiction severity ,more frequently violent behavior and involuntary admission than PASP group (p<0.001). 3) PPSA group were mainly consisted with schizophrenia (39.1%), mood disorder (21.7%) and major depressive disorder (17.4%) but PASP group were mainly occupied with major depressive disorder (40.7%), personality disorders (30.5%) and anxiety disorder (6.8%).

Conclusion：There were many clinical differences between PPSA group and PASP group of recognition of addiction severity, violent behavior, mode of admission and history of suicide. Two groups were dual diagnosed alcoholics and mentally ill patients but PPSA group which have primary psychiatric disorder were more treatment resisted and complicated “highly risk” group than PASP group which have primary alcohol dependence. There-fore, it is required that therapists consider more intensive evaluation and treatment approach according to their function in dual diagnosed psychiatric patients.


Key words : Dual diagnosis;Alcohol dependence;Mentally ill patients.