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Who receives treatment for alcohol use disorders in the European Union? A cross-sectional representative study in primary and specialized health care

Published online by Cambridge University Press:  05 October 2015

J. Rehm ,
J. Manthey ,
P. Struzzo ,
A. Gual  and
M. Wojnar
J. Rehm
Affiliation:
Centre for Addiction and Mental Health, 33, Russell Street, Toronto, ONM5S 2S1, Canada Addiction Policy, Dalla Lana School of Public Health, University of Toronto, 155, College Street, 6th floor, Toronto, ONM5T 3M7, Canada Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1, King's College Circle, Room 2374, Toronto, ONM5S 1A8, Canada Department of Psychiatry, University of Toronto, 250, College Street, 8th floor, Toronto, ONM5T 1R8, Canada Institute of Clinical Psychology and Psychotherapy & Centre of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187Dresden, Germany
J. Manthey*
Affiliation:
Institute of Clinical Psychology and Psychotherapy & Centre of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187Dresden, Germany
P. Struzzo
Affiliation:
Regional Centre for the Training in Primary Care (Ceformed), Via Galvani 1, 34074Monfalcone, GO, Italy University of Trieste, Department of Life Sciences, Via Weiss 2, 34128Trieste, Italy
A. Gual
Affiliation:
Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, Carrer Villarroel 170, 08036Barcelona, Catalonia, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer Rosselló 149, 08036Barcelona, Catalonia, Spain Red de Trastornos Adictivos (RTA–RETICS), Instituto de Salud Carlos III, Villarroel 170, 08036Barcelona, Catalonia, Spain
M. Wojnar
Affiliation:
Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665Warsaw, Poland Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI48109, USA
*
⁎Corresponding author. E-mail address:[email protected] (J. Manthey).
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Abstract

Background

Alcohol use disorders (AUDs) are highly prevalent in Europe, but only a minority of those affected receive treatment. It is therefore important to identify factors that predict treatment in order to reframe strategies aimed at improving treatment rates.

Methods

Representative cross-sectional study with patients aged 18–64 from primary health care (PC, six European countries, n = 8476, data collection 01/13–01/14) and from specialized health care (SC, eight European countries, n = 1762, data collection 01/13–03/14). For descriptive purposes, six groups were distinguished, based on type of DSM-IV AUD and treatment setting. Treatment status (yes/no) for any treatment (model 1), and for SC treatment (model 2) were main outcome measures in logistic regression models.

Results

AUDs were prevalent in PC (12-month prevalence: 11.8%, 95% confidence interval (CI): 11.2–12.5%), with 17.6% receiving current treatment (95%CI: 15.3–19.9%). There were clear differences between the six groups regarding key variables from all five predictor domains. Prediction of any treatment (model 1) or SC treatment (model 2) was successful with high overall accuracy (both models: 95%), sufficient sensitivity (model 1: 79%/model 2: 76%) and high specificity (both models: 98%). The most predictive single variables were daily drinking level, anxiety, severity of mental distress, and number of inpatient nights during the last 6 months.

Conclusions

Variables from four domains were highly predictive in identifying treatment for AUD, with SC treatment groups showing very high levels of social disintegration, drinking, comorbidity and functional losses. Earlier intervention and formal treatment for AUD in PC should be implemented to reduce these high levels of adverse outcomes.

Keywords

Alcohol use disorderAlcohol dependenceTreatmentSpecialized carePrimary careEurope
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015 , pp. 885 - 893
Copyright
Copyright © European Psychiatric Association 2020

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Footnotes

1

Joint last authorship.

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