Investigation of the frequency of alcohol related problems in Józsefváros, Budapest. Data and conclusions of three surveys undertaken among doctors and out-patients

Abstract

The role of permanent alcohol consumption in the development of diseases is well-known. Aims: To study the occurence of alcohol related problems among patients of a municipal pulmonology out-patient clinic as well as in the family practice of three physicians. In addition, a survey was performed among physicians of a municipal health service and also among family practitioners working in the same district by investigating health problems, habits and professional careers of physicians, and their addictive problems, their attitude toward addict patients and their opinion upon chemical dependency. Methods: CAGE-test was used to examine the presence of alcohol problem and a questionnaire was constructed for the study undertaken among physicians. Results: The response rate was 60.18% and 32.98% among patients who visited the pulmonology out-patient clinic and their family physician, respectively. Among those who responded to the test, as many as 6.02% and 4.82% of the cases would need a further medical examination to make clear whether alcohol related health problem was present or not, whilst 9.77% and 11.67% of the patients proved to be alcohol dependent, respectively. The response rate in the survey among physicians was 41.28%. As stated, physicians not only screen the patients for alcohol and drug dependence, but also refer them to a specialist. The general experience seems to oppose this statement. The majority of health professionals considered chemical dependence as a chronic disease, whereas a kind of moral judgment of the problem was also seen, particularly among family physicians. If they had the opportunity to choose whom to treat: an alcoholic or a drug dependent patient, the majority of them would treat patients brought under the first category. The CAGE test revealed alcohol problem in three family physicians, but none in specialists. Nearly all physicians consumed coffee, but the majority of them were non-smokers. As the risk for committing suicide is higher among physicians than in the general population, physicians were interviewed in this regard, too. Three physicians in the sample reported an attempt of suicide, and eleven physicians had suicidal ideas in the past. Although the majority of physicians were satisfied with their physical and mental health, several of them had serious health problems or were treated with depression. At the same time, the majority of physicians were unsatisfied with their financial and professional respect, and had the opinion that a career is unlikely to depend on the professional knowledge. Discussion: Although the relatively low rate of physicians answering the questions did not make it possible to reveal the interrelationships among different variables, the study was able to direct the attention to the risk existing among physicians to commit suicide or use chemical substances. A proposal is made to establish an effective, but discreet and easy way to acquire psychiatric-addictological support. To avoid mental health problems among professionals working in psychiatry, organization of groups headed by someone not belonging to the same institute would be warmly encouraged. Parallel to these, the requirements and the conditions of making a career have to be made clear. On the basis of these surveys, as well as literature data, a continuous test examination of alcohol problem is recommended in the practice of family physicians as well as in the out-patient clinic of such disciplines like pulmonology and gastroenterology. Orv. Hetil., 2012, 153, 1263–1280.