Correlates of depression among heavy drinkers in Polish primary care clinics.

OBJECTIVE: Depression and co-morbid substance abuse disorders are a major public health problem. Information is limited for patients attending Polish primary care clinics. This article addresses 30-day and lifetime prevalence of major depression in a heavy drinking population from 12 Polish primary care clinics. METHOD: 277 heavy drinkers were interviewed by a researcher in each clinic. Heavy drinking was defined as more than 20 drinks per week for males, or more than 13 drinks per week for females, or consumption of more than four drinks five or more times in the previous 30 days, or two or more positive replies to the CAGE questions. Criteria from the Diagnostic and Statistical Manual were used to assess lifetime and past 30-day depression. RESULTS: 35% of women and men met criteria for depression in the 30 days prior to the interview. Lifetime rates were 45% for women and 52% for men. Men and women with a CAGE score of 4 were at higher risk for both 30-day (67%, OR = 3.85 [1.47, 10.08]) and lifetime (78%, OR = 3.28 [1.12, 9.66]) depression. Recreational drug users and patients reporting symptoms of anti-social personality disorders were at increased risk for lifetime depression. Subjects reporting symptoms of a childhood conduct disorder were at higher risk for 30-day depression. CONCLUSIONS: Depression among patients with substance abuse problems is a common problem. The rates are higher than for other countries and highlight the need for Polish primary care clinicians to routinely screen for depression in patients with substance use disorders.

Prevalence of tobacco and alcohol use disorders in Polish primary care settings.

BACKGROUND: Primary care settings are an ideal system in which to identify and treat tobacco and alcohol use disorders. This project surveyed patients from the offices of 20 Polish primary care clinicians to ascertain the prevalence of tobacco and alcohol use by gender and age. METHODS: A total of 4373 adults aged 18-80 years seeking routine care completed a nurse-administered Health Screening Survey as part of a clinical trial designed to assess the efficacy of brief physician advice on heavy alcohol use. RESULTS: Of the 4373 subjects screened, 44.4% reported cigarette use within the past three months. Most perceived smoking as a problem and had considered reducing their tobacco use. A stepwise model to examine factors that predict smoking status found that alcohol consumption was the best predictor of current cigarette use. Alcohol consumption was common, with 64% of the subjects reporting some use within the previous three months. Of these, 55% were classified as low risk drinkers, 14% as at-risk drinkers, 12% as problem drinkers, and 19% as dependent drinkers. CONCLUSION: This is the first report on the combined prevalence of tobacco and alcohol use disorders in a sample of persons attending community-based primary care clinics in Poland. This report confirms the high prevalence of these problems and suggests that patients will accurately complete a screening test such as the Health Screening Survey. The methods employed for this study provide the Polish health care system with a procedure to effectively screen patients for tobacco and alcohol use disorders.