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Young female psychiatric patients' reasons for excessive alcohol use: a qualitative interview study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
2013 (English)In: Mental Health and Substance Use, ISSN 1752-3281, E-ISSN 1752-3273, Vol. 6, no 4, 315-324 p.Article in journal (Refereed) Published
Abstract [en]

There is a strong and multidirectional link between excessive alcohol use and psychiatric disorders. A large proportion (46.6%) of young female psychiatric outpatients report drinking above hazardous levels. This study explores high risk-drinking young female psychiatric patients' view of the role of alcohol in their lives. A further aim was to identify factors that may facilitate changes in drinking habits. Semi-structured interviews with open-ended questions were performed. The main areas of interest were: positive/negative aspects of alcohol use, risk situations for excessive drinking and factors facilitating change in drinking habits. Data were analysed using qualitative content analysis, a process that includes identifying, coding and categorizing components of the interviews. Nine female high risk-drinking psychiatric patients (mean age 22.2 ± 3.5 years) were interviewed. The reasons for excessive alcohol use were either external, in which case the young females wanted to live up to social expectations, or internal, in which case alcohol was used as an escape from negative feelings or for the purpose of self-harm. The participants requested help from psychiatric care-givers to focus on reasons for drinking and help with addressing underlying needs more functionally. To help avoid the development of complicated comorbidity, psychiatric providers must be aware of the role of alcohol in the patient's life. The categories identified in this study can be used by psychiatric health-care professionals in an interview scheme or checklist when meeting young female patients with excessive drinking.

Place, publisher, year, edition, pages
2013. Vol. 6, no 4, 315-324 p.
Keyword [en]
Young females, risk drinking, hazardous alcohol use, harmful alcohol use, psychiatric patients, qualitative
National Category
Medical and Health Sciences
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-179332DOI: 10.1080/17523281.2012.755559OAI: oai:DiVA.org:uu-179332DiVA: diva2:544207
Available from: 2012-08-13 Created: 2012-08-13 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Alcohol Use and Secondary Prevention in Psychiatric Care
Open this publication in new window or tab >>Alcohol Use and Secondary Prevention in Psychiatric Care
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Although alcohol plays an important role in psychiatric morbidity, there is a general lack of strategies within psychiatric care to intervene at alcohol problems in an early stage (secondary prevention). The aim of this thesis was to increase knowledge of adequate forms of secondary alcohol prevention in psychiatric care.  

The capacity of three brief screening instruments was investigated in a psychiatric outpatient sample (n=1811). The results indicate that the HED (heavy episodic drinking) screener, strongly recommended for health care settings, is not sufficiently sensitive in a psychiatric setting. Instead, the full AUDIT (Alcohol Use Disorders Identification Test) is recommended.

The knowledge and attitudes of psychiatric staff members to problem-drinking patients were studied and the effects of a three-hour training course were investigated. Confidence in self-perceived capacity to intervene in more severe alcohol problems was raised among all staff after training. Awareness of early signs of problem drinking was raised among psychologists and social workers. The therapeutic attitude of the psychiatric staff was higher when compared with primary care staff.

Two forms of brief intervention were delivered by clinical psychiatric staff. At 12 months, 29% of all participants had improved their drinking habits, moving from hazardous to non-hazardous level (21%) or from harmful to hazardous level (8%). In the improved group, mean AUDIT score was reduced from 11.0 points at baseline to 5.5 points. Differences in outcome between the two interventions could not be identified.

Nine high-risk drinking young female psychiatric patients were interviewed, focusing on reasons for excessive drinking and factors facilitating a change in drinking habits. Alcohol played an important role in the lives of the young women. It made them feel social and helped them deal with unbearable emotions. It was also used as a means of self-harm, representing the first stage in an escalating self-harm process. They expressed a need for help from their caregivers in addressing the underlying reasons for drinking.

Secondary alcohol prevention strategies including appropriate screening methods, staff training and the elaboration of tailored interventions are urgently needed in psychiatric care. The findings of this thesis can be used when forming such strategies.  

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 47 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 803
Keyword
hazardous alcohol use, risk drinking, brief intervention, screening methods, staff training
National Category
Medical and Health Sciences
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-179175 (URN)978-91-554-8451-4 (ISBN)
Public defence
2012-10-19, Gustavianum, auditorium Minus, Akademigatan 3, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-09-21 Created: 2012-08-08 Last updated: 2013-01-22Bibliographically approved

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Nehlin Gordh, ChristinaFredriksson, AndersÖster, Caisa

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