Nijmegen Institute for Scientist-Practitioners in Addiction

[Demoralisation in alcohol-dependent patients with co-occurring psychiatric disorders].

Titel[Demoralisation in alcohol-dependent patients with co-occurring psychiatric disorders].
PublicatietypeJournal Article
Jaar van publicatie2019
Auteursvan Oene GH de Weert, de Jong CAJ
UitgaveTijdschr Psychiatr
TrefwoordenAdult, Aged, Alcoholism, Anxiety Disorders, Comorbidity, Depressive Disorder, Female, Humans, Male, Middle Aged, Morale, Personality Disorders, Young Adult

BACKGROUND: Demoralisation is a multidimensional concept, with helplessness and hopelessness as its key elements. Many patients, both in somatic and in mental health care, suffer from demoralisation. In the process of recovery, remoralisation constitutes a first step.
AIM: To investigate demoralisation in alcohol-dependent inpatients with co-occurring psychiatric disorders.
METHOD: Included in this study were 159 alcohol-dependent inpatients admitted to clinics for dual diagnosis. Demoralisation was assessed at treatment entry and again one month later.
RESULTS: A strong level of demoralisation was found, particularly in the co-occurrence of depression, anxiety and personality disorders. At treatment entry, 92% of patients was clinically demoralised and, one month later, this was 89%. In patients with co-occurring depression, mood and personality disorders, a significant decrease of demoralisation was found after one month, whereas in patients with developmental and psychotic disorders this was not the case. In 11% of patients there was clinically relevant improvement and in 7.5% there was clinically relevant deterioration; the latter mainly in patients with co-occurring developmental and psychotic disorders.
CONCLUSION: At start of treatment, these alcohol-dependent patients were strongly demoralised, especially in the co-occurrence of psychiatric disorders. Although there was a significant improvement in demoralisation after one month of treatment, patients remained strongly demoralised. In one in ten patients there was clinically relevant remoralisation. As a first step in the process of recovery, clinicians should pay more attention to remoralisation. Targeted interventions, aimed at this specific population, are necessary.

Alternatieve uitgaveTijdschr Psychiatr
PubMed ID30793268