The problem of alcohol in the medical/surgical patient.

The authors report the results of a computerized data-based study of 845 general hospital patients seen by a consultation-liaison psychiatry service in a major urban hospital. The findings indicate that only 5.2% of the referrals were for the problem of alcohol. Furthermore, the detection rate of an alcohol problem by both the referring physicians and the psychiatric consultants was low (8.3%) as compared with the literature's reported prevalence rate of alcoholism in the general hospital (8.7%-55%). The problem of recognition of an alcohol problem in the medical/surgical patient is explored with particular emphasis on the obstacles to diagnosis--masking of alcoholism by other major psychiatric disease, the categorization of patients by symptom rather than underlying causation, and the lack of sufficient employment of useful diagnostic screening devices.