SCREENING FOR ALCOHOLISM IN GENERAL HOSPITALS

In a recently completed study at the North Bay Psychiatric Hospital, a tertiary resource serving a population of about 600,000 in Northern O ntario, systematic screening on admission showed a very high proportio n of past or present alcoholism. Fifty-seven percent of the patients w ere identified as having a life prevalence of (current or past) alcoho l-related problems through a combination of a questionnaire and a live r function test. This figure is much higher than what is generally obs erved in mental hospitals. Does it reflect a widespread prevalence of alcoholism in Northeastern Ontario or is it distorted by the pattern o f referral to the North Bay Psychiatric Hospital which typically serve s an under-privileged segment of the population? In an attempt to answ er this question, this study was carried out in general hospitals (med ical and surgical wards). It confirms a higher prevalence of alcohol-r elated problems (biological, psychological and/or social) in Northern Ontario general hospitals, compared with Southern Ontario general hosp itals, using identical methods of screening and assessment in both pop ulations. The regional difference (odds ratio) is more evident in high er social classes. A diagnosis of alcohol abuse or dependence (current ly active or in remission) was confirmed in 83.5% of the cases with po sitive screening who underwent the Diagnostic Interview Schedule (revi sed). This is a robust confirmation of the value of screening. These f indings confirm the importance of systematic screening for alcoholism in general hospitals.