Jürgen Rehm1, Allaman Allamani1, Roberto Della Vedova1, Zsuzsanna Elekes1, Andrzej Jakubczyk1, Inga Landsmane1, Jakob Manthey2, José Moreno-España1, Lars Pieper1, Charlotte Probst1, Sigita Snikere1, Pierluigi Struzzo1, Fabio Voller1, Hans-Ulrich Wittchen1, Antoni Gual1, Marcin Wojnar1. 1. Centre for Addiction and Mental Health, Toronto, Canada (J.R.); Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (J.R.); Institute of Medical Science, University of Toronto, Faculty of Medicine, Toronto, Canada (J.R.); Department of Psychiatry, University of Toronto, Toronto, Canada (J.R.); Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany (J.R., J.M., L.P., C.P., H-U.W.); Agenzia Regionale di Sanità Toscana, Villa la Quiete alle Montalve, Firenze, Italy (A.A., F.V.); Regional Centre for the Training in Primary Care (Ceformed), Monfalcone (GO), Italy (R.D.V., P.S.); Center for Study and Research in General Practice (CSeRMEG), Via Praga, 22, 20052 Monza (MI), Italy (R.D.V.); Corvinus University of Budapest, Budapest, Hungary (Z.E.); Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland (A.J., M.W.); Riga Centre of Psychiatry and Addiction Medicine, Riga, Latvia (I.L.); Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain (J.M-E.); Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, Barcelona, Spain (J.M-E., A.G.); Institute of Sociological Research, Riga, Latvia (S.S.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.G.); Red de Trastornos Adictivos (RTA -RETICS), Instituto de Salud Carlos III, Barcelona, Spain (A.G.); Department of Psychiatry, University of Michigan, Ann Arbor, Michigan (M.W.). 2. Centre for Addiction and Mental Health, Toronto, Canada (J.R.); Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (J.R.); Institute of Medical Science, University of Toronto, Faculty of Medicine, Toronto, Canada (J.R.); Department of Psychiatry, University of Toronto, Toronto, Canada (J.R.); Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany (J.R., J.M., L.P., C.P., H-U.W.); Agenzia Regionale di Sanità Toscana, Villa la Quiete alle Montalve, Firenze, Italy (A.A., F.V.); Regional Centre for the Training in Primary Care (Ceformed), Monfalcone (GO), Italy (R.D.V., P.S.); Center for Study and Research in General Practice (CSeRMEG), Via Praga, 22, 20052 Monza (MI), Italy (R.D.V.); Corvinus University of Budapest, Budapest, Hungary (Z.E.); Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland (A.J., M.W.); Riga Centre of Psychiatry and Addiction Medicine, Riga, Latvia (I.L.); Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain (J.M-E.); Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, Barcelona, Spain (J.M-E., A.G.); Institute of Sociological Research, Riga, Latvia (S.S.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.G.); Red de Trastornos Adictivos (RTA -RETICS), Instituto de Salud Carlos III, Barcelona, Spain (A.G.); Department of Psychiatry, University of Michigan, Ann Arbor, Michigan (M.W.). johann_jakob.manthey@mailbox.tu-dresden.de.
Abstract
PURPOSE: Although alcohol dependence causes marked mortality and disease burden in Europe, the treatment rate is low. Primary care could play a key role in reducing alcohol-attributable harm by screening, brief interventions, and initiating or referral to treatment. This study investigates identification of alcohol dependence in European primary care settings. METHODS: Assessments from 13,003 general practitioners, and 9,098 interviews (8,476 joint number of interviewed patients with a physician's assessment) were collected in 6 European countries. Alcohol dependence, comorbidities, and health service utilization were assessed by the general practitioner and independently using the Composite International Diagnostic Interview (CIDI) and other structured interviews. Weighted regression analyses were used to compare the impact of influencing variables on both types of diagnoses. RESULTS: The rate of patients being identified as alcohol dependent by the CIDI or a general practitioner was about equally high, but there was not a lot of overlap between cases identified. Alcohol-dependent patients identified by a physician were older, had higher rates of physicial comorbidity (liver disease, hypertension), and were socially more marginalized, whereas average consumption of alcohol and mental comorbidity were equally high in both groups. CONCLUSION: General practitioners were able to identify alcohol dependence, but the cases they identified differed from cases identified using the CIDI. The role of the CIDI as the reference standard should be reexamined, as older alcohol-dependent patients with severe comorbidities seemed to be missed in this assessment.
PURPOSE: Although alcohol dependence causes marked mortality and disease burden in Europe, the treatment rate is low. Primary care could play a key role in reducing alcohol-attributable harm by screening, brief interventions, and initiating or referral to treatment. This study investigates identification of alcohol dependence in European primary care settings. METHODS: Assessments from 13,003 general practitioners, and 9,098 interviews (8,476 joint number of interviewed patients with a physician's assessment) were collected in 6 European countries. Alcohol dependence, comorbidities, and health service utilization were assessed by the general practitioner and independently using the Composite International Diagnostic Interview (CIDI) and other structured interviews. Weighted regression analyses were used to compare the impact of influencing variables on both types of diagnoses. RESULTS: The rate of patients being identified as alcohol dependent by the CIDI or a general practitioner was about equally high, but there was not a lot of overlap between cases identified. Alcohol-dependent patients identified by a physician were older, had higher rates of physicial comorbidity (liver disease, hypertension), and were socially more marginalized, whereas average consumption of alcohol and mental comorbidity were equally high in both groups. CONCLUSION: General practitioners were able to identify alcohol dependence, but the cases they identified differed from cases identified using the CIDI. The role of the CIDI as the reference standard should be reexamined, as older alcohol-dependent patients with severe comorbidities seemed to be missed in this assessment.
Authors: T Bedirhan Ustün; Somnath Chatterji; Nenad Kostanjsek; Jürgen Rehm; Cille Kennedy; Joanne Epping-Jordan; Shekhar Saxena; Michael von Korff; Charles Pull Journal: Bull World Health Organ Date: 2010-05-20 Impact factor: 9.408
Authors: Susanne Rösner; Andrea Hackl-Herrwerth; Stefan Leucht; Philippe Lehert; Simona Vecchi; Michael Soyka Journal: Cochrane Database Syst Rev Date: 2010-09-08
Authors: H U Wittchen; F Jacobi; J Rehm; A Gustavsson; M Svensson; B Jönsson; J Olesen; C Allgulander; J Alonso; C Faravelli; L Fratiglioni; P Jennum; R Lieb; A Maercker; J van Os; M Preisig; L Salvador-Carulla; R Simon; H-C Steinhausen Journal: Eur Neuropsychopharmacol Date: 2011-09 Impact factor: 4.600
Authors: Stephen S Lim; Theo Vos; Abraham D Flaxman; Goodarz Danaei; Kenji Shibuya; Heather Adair-Rohani; Markus Amann; H Ross Anderson; Kathryn G Andrews; Martin Aryee; Charles Atkinson; Loraine J Bacchus; Adil N Bahalim; Kalpana Balakrishnan; John Balmes; Suzanne Barker-Collo; Amanda Baxter; Michelle L Bell; Jed D Blore; Fiona Blyth; Carissa Bonner; Guilherme Borges; Rupert Bourne; Michel Boussinesq; Michael Brauer; Peter Brooks; Nigel G Bruce; Bert Brunekreef; Claire Bryan-Hancock; Chiara Bucello; Rachelle Buchbinder; Fiona Bull; Richard T Burnett; Tim E Byers; Bianca Calabria; Jonathan Carapetis; Emily Carnahan; Zoe Chafe; Fiona Charlson; Honglei Chen; Jian Shen Chen; Andrew Tai-Ann Cheng; Jennifer Christine Child; Aaron Cohen; K Ellicott Colson; Benjamin C Cowie; Sarah Darby; Susan Darling; Adrian Davis; Louisa Degenhardt; Frank Dentener; Don C Des Jarlais; Karen Devries; Mukesh Dherani; Eric L Ding; E Ray Dorsey; Tim Driscoll; Karen Edmond; Suad Eltahir Ali; Rebecca E Engell; Patricia J Erwin; Saman Fahimi; Gail Falder; Farshad Farzadfar; Alize Ferrari; Mariel M Finucane; Seth Flaxman; Francis Gerry R Fowkes; Greg Freedman; Michael K Freeman; Emmanuela Gakidou; Santu Ghosh; Edward Giovannucci; Gerhard Gmel; Kathryn Graham; Rebecca Grainger; Bridget Grant; David Gunnell; Hialy R Gutierrez; Wayne Hall; Hans W Hoek; Anthony Hogan; H Dean Hosgood; Damian Hoy; Howard Hu; Bryan J Hubbell; Sally J Hutchings; Sydney E Ibeanusi; Gemma L Jacklyn; Rashmi Jasrasaria; Jost B Jonas; Haidong Kan; John A Kanis; Nicholas Kassebaum; Norito Kawakami; Young-Ho Khang; Shahab Khatibzadeh; Jon-Paul Khoo; Cindy Kok; Francine Laden; Ratilal Lalloo; Qing Lan; Tim Lathlean; Janet L Leasher; James Leigh; Yang Li; John Kent Lin; Steven E Lipshultz; Stephanie London; Rafael Lozano; Yuan Lu; Joelle Mak; Reza Malekzadeh; Leslie Mallinger; Wagner Marcenes; Lyn March; Robin Marks; Randall Martin; Paul McGale; John McGrath; Sumi Mehta; George A Mensah; Tony R Merriman; Renata Micha; Catherine Michaud; Vinod Mishra; Khayriyyah Mohd Hanafiah; Ali A Mokdad; Lidia Morawska; Dariush Mozaffarian; Tasha Murphy; Mohsen Naghavi; Bruce Neal; Paul K Nelson; Joan Miquel Nolla; Rosana Norman; Casey Olives; Saad B Omer; Jessica Orchard; Richard Osborne; Bart Ostro; Andrew Page; Kiran D Pandey; Charles D H Parry; Erin Passmore; Jayadeep Patra; Neil Pearce; Pamela M Pelizzari; Max Petzold; Michael R Phillips; Dan Pope; C Arden Pope; John Powles; Mayuree Rao; Homie Razavi; Eva A Rehfuess; Jürgen T Rehm; Beate Ritz; Frederick P Rivara; Thomas Roberts; Carolyn Robinson; Jose A Rodriguez-Portales; Isabelle Romieu; Robin Room; Lisa C Rosenfeld; Ananya Roy; Lesley Rushton; Joshua A Salomon; Uchechukwu Sampson; Lidia Sanchez-Riera; Ella Sanman; Amir Sapkota; Soraya Seedat; Peilin Shi; Kevin Shield; Rupak Shivakoti; Gitanjali M Singh; David A Sleet; Emma Smith; Kirk R Smith; Nicolas J C Stapelberg; Kyle Steenland; Heidi Stöckl; Lars Jacob Stovner; Kurt Straif; Lahn Straney; George D Thurston; Jimmy H Tran; Rita Van Dingenen; Aaron van Donkelaar; J Lennert Veerman; Lakshmi Vijayakumar; Robert Weintraub; Myrna M Weissman; Richard A White; Harvey Whiteford; Steven T Wiersma; James D Wilkinson; Hywel C Williams; Warwick Williams; Nicholas Wilson; Anthony D Woolf; Paul Yip; Jan M Zielinski; Alan D Lopez; Christopher J L Murray; Majid Ezzati; Mohammad A AlMazroa; Ziad A Memish Journal: Lancet Date: 2012-12-15 Impact factor: 79.321
Authors: E F S Kaner; F Beyer; H O Dickinson; E Pienaar; F Campbell; C Schlesinger; N Heather; J Saunders; B Burnand Journal: Cochrane Database Syst Rev Date: 2007-04-18
Authors: Sören Kuitunen-Paul; Jürgen Rehm; Dirk W Lachenmeier; Firdeus Kadrić; Paula T Kuitunen; Hans-Ulrich Wittchen; Jakob Manthey Journal: Int J Methods Psychiatr Res Date: 2017-03-28 Impact factor: 4.035
Authors: Shari Rogal; Ada Youk; Hongwei Zhang; Walid F Gellad; Michael J Fine; Chester B Good; Maggie Chartier; Andrea DiMartini; Timothy Morgan; Ramon Bataller; Kevin L Kraemer Journal: Hepatology Date: 2020-05-22 Impact factor: 17.425
Authors: A Luquiens; D Whalley; P Laramée; B Falissard; N Kostogianni; J Rehm; J Manthey; F Paille; H J Aubin Journal: Qual Life Res Date: 2015-11-20 Impact factor: 4.147
Authors: Jürgen Rehm; Allaman Allamani; Zsuzsanna Elekes; Andrzej Jakubczyk; Jakob Manthey; Charlotte Probst; Pierluigi Struzzo; Roberto Della Vedova; Antoni Gual; Marcin Wojnar Journal: BMC Fam Pract Date: 2015-07-29 Impact factor: 2.497
Authors: Maria Neufeld; Jürgen Rehm; Anna Bunova; Artyom Gil; Boris Gornyi; Pol Rovira; Jakob Manthey; Elena Yurasova; Svetlana Dolgova; Bulat Idrisov; Marina Moskvicheva; Galina Nabiullina; Olga Shegaym; Irina Zhidkova; Zukhra Ziganshina; Carina Ferreira-Borges Journal: Bull World Health Organ Date: 2021-03-19 Impact factor: 9.408