Morbidity patterns in hazardous drinkers: relevance of demographic, sociologic, drinking, and drug use characteristics.

A profile of the demographic, sociologic, drug use, and drinking characteristics of a large group of inpatient alcoholics has been constructed as background for discussion of the clinical significance of these factors as determinants of physical morbidity in hazardous drinkers. Factors specifically considered include sex, skid row status, social class, and abnormal use of drugs of dependence, the amount of alcohol consumed and duration of drinking, drinking pattern, and type of beverage. While heavy drinking is of primary importance, the physical disease profile found in hazardous drinkers is modified by certain host and environmental characteristics. The implications for treatment planning and preventive programs are considered.

Some simple facts about urinary incontinence in the elderly.

Incontinence can be caused by physiological changes, neurological disorders, trauma, certain drugs, and environmental factors. This article takes each of these causes step by step, suggesting methods of treatment and prevention.

An epidemiologist looks at retirement.

In projecting future needs in health and social services, one needs not only a knowledge of disease processes and demography, but also social and political factors which may influence the make up and disposition of the population. This article is a look at some of the trends which will influence our handling of the aging population.

Morbidity in alcoholics. Evidence for accelerated development of physical disease in women.

The physical disease profiles of 135 female and 736 male inpatient alcoholics, similar in age, social class, and referral pattern, were compared to further clarify the widespread clinical impression that female alcoholics are more illness-prone. Although the women had been drinking hazardously for fewer years, at admission the prevalence of most diseases was similar in men and women. There was, however, an excess of anemia in women and of fatty liver and chronic obstructive lung disease in men. Furthermore, the average duration of hazardous drinking before the first recorded occurrence of almost all illness events was shorter in women, the sex differences being statistically significant for fatty liver, hypertension, obesity, anemia, malnutrition, gastrointestinal hemorrhage, and an ulcer requiring surgery. These findings suggest that the development of physical morbidity in relation to hazardous drinking may be accelerated in women.

Social class and morbidity in clinically treated alcoholics.

The lifetime physical disease profiles of 122 lower and 724 middle class non-skid row alcoholics admitted to an inpatient treatment facility were compared to further clarify the significance of social class as a determinant of morbidity in alcoholics. The overall severity of physical disease and the frequency of all recorded lifetime illness diagnoses were greater in the lower than in the middle class. The former experienced more trauma, genitourinary disorders, venereal disease and malnutrition, as well as small excesses of respiratory and nervous system disorders. There were no class differences in the lifetime frequencies of liver and biliary tract, gastrointestinal, cardiovascular, endocrine and metabolic, integumentary, locomotor and haemopoietic disorders, or in the incidences of a number of disease entities including acute brain syndromes and chronic brain damage. The drinking patterns of the classes were similar, but the average duration of hazardous drinking was longer and the average current consumption was greater in the lower class. There were no class differences, however, in the average duration of hazardous drinking before the first occurrence of certain diseases. The referral sources of the classes were significantly different. Possible explanations for the differences between the findings of this and earlier studies are discussed.

Skid row alcoholism. A distinct sociomedical entity.

The physical-disease charcteristics of 125 skid row and 736 non-skid row male alcoholics were compared in detail to determine whether skid row alcoholism is characterized by a distinct medical, as well as a social, profile. Trauma, tuberculosis, venereal disease, and malnutrition were more common in the skid row alcoholics. Epilepsy, peripheral neuritis, acute brain syndromes, chronic brain disease, and lifetime recordings of all nervous system illnesses also occurred more frequently in the skid row group, as did gastritis, gastrointestinal hemorrhage, ulcer surgery, and postgastrectomy syndrome. Fatty liver, hypertension, ischemic heart disease, cardiomyopathy, and cardiovascular illnesses of all kinds, however, were less common. The skid row medical profile is, in part, the product of a unique sociologic environment. Thus, skid row alcoholism may be viewed as a distinct sociomedical entity.