Severity of withdrawal in subjects exposed to a combination of alcohol and minor tranquillisers.

Fifty patients suffering from the alcohol dependence syndrome were detoxified over a 10-day period using a reducing regime of chlordiazepoxide. Twenty-four had been consuming minor tranquillisers together with alcohol prior to admission. The severity of the withdrawal syndrome was assessed daily but no differences were found between the 26 who had taken alcohol alone and the 24 who had taken a combination of alcohol and drugs. Four from each group had a transient hallucinosis and none had fits.

Sexual jealousy in alcoholics.

A hundred patients referred to an alcoholism service were assessed in terms of sexual jealousy by interview and with a Sexual Jealousy Questionnaire. The overall incidence of sexual jealousy was 35% in men and 31% in women as judged by the interview. Twenty-seven per cent of the men and 15% of the women had morbid jealousy. There was no relationship between sexual jealousy, as measured by the questionnaire, and sexual dysfunction. However, in the men there were inverse relationships between the scores for sexual jealousy and measures of sexual satisfaction and marital stability, and in the women sexual jealousy scores correlated negatively with duration of the marriage and positively with severity of alcohol dependence.

The Manchester detoxification service. Description and evaluation.

The service of Manchester's hospital-based purpose-built alcohol detoxification centre is described, together with demographic data, drinking history, findings on admission, disposal arrangements, and outcome of 235 police referrals. Police referrals under-used the centre, which now accepts from magistrates' courts, the local alcoholism council, accident and emergency departments, and general practice. Police referrals, mostly homeless and without family support, contained many episodic drinkers; this explains the low incidence of severe withdrawal symptoms. Prophylactic treatment was not routine. Very high blood alcohol levels were recorded from some conscious patients. There was little serious medical morbidity. Many discharged themselves within 24 hours. Few accepted the recommended treatment, medical or social; prolonged abstinence was achieved by only 1% but substantially more had short abstinent periods and some social betterment, especially if offered follow-up help. Visits to general practitioners' surgeries fell during the follow-up period, as did admissions to general units for withdrawal symptoms, though not from all causes. Almost half had readmissions to the centre. Referrals from other sources were more likely to stay for assessment and accept help. More referrals from medical sources had severe withdrawal symptoms. Detoxification centres need not be in hospitals but must have close and rapid links with specialist medical services. They must be integrated into the total provision of alcoholism services and assessed in relation to them.

Some factors associated with compliance in the treatment of alcoholism.

The investigation set out to examine the extent of problems of low compliance at an alcoholism clinic, to investigate some variables that might differentiate referral failures and initial clinic attenders as well as categories of patients who attend for treatment, and to generate hypotheses concerning these differences as a means of developing a compliance-enhancement strategy. Information, including sociodemographic and personality variables, patient self-reports of drinking behaviour, self-perceptions of their need for help and of drinking problem severity, and therapist ratings of drinking problem severity, was gathered on one hundred referrals to a clinic for new patients. Results showed that 46% of patients were referral failures and that, in comparison with attenders, the former group had both waited longer for the initial appointment and were younger. Few variables differentiated the categories of attenders. A greater proportion of those remaining in treatment contact for longer than a month rated the change in their drinking problem over the previous year as 'worse' and more of them had been arrested for public drunkenness. Those who made five or more clinic visits had waited a shorter time for their initial appointment, and a greater proportion rated the effects of their drinking on their work as 'serious' and the change in their social life as 'worse' than patients who had made fewer visits. The findings suggest that variables related to personal perceptions of drinking problems offer a better account of compliance behaviour than the sociodemographic variables which have been the focus of previous research.

A general-practice study of the commonest presenting symptoms of alcoholism.

In general practice alcoholism should be considered when the doctor detects marital disharmony, repeated sickness absenteeism, repeated aggressive behaviour, patients who are in debt, patients in trouble with the Law, patients with frequent upset stomachs for no obvious reason, patients presenting with anxiety and depression, and those who smell of drink.

Changes in construing and outcome of group therapy for alcoholism.

Consistent changes in the way they construed their drinking problem were found in alcoholics who completed an inpatient group therapy program. Patients who showed most change in construal were the ones most likely to relapse.