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Psychiatry Lite

While it is well known that psychiatric disorders often co-occur with substance-abuse disorders – called co-morbidity – it is often unclear which symptoms are a result of which disorder. Most studies only measure psychiatric illnesses severe enough that they meet diagnostic thresholds. This study proposes a “sub-diagnostic” approach, measuring psychiatric co-morbidity among alcoholics along a continuum of symptoms.

Researchers examined two groups recruited from the community: 48 (25 men, 23 women) long-term abstinent alcoholics, and 48 age- and gender-matched light or non-drinking “controls.” Continuous measures of pathology were used, such as symptom counts and psychological assessments, in the domains of anxiety, mood, and externalizing pathology.

Using this broader range of criteria, the psychiatric symptom counts and psychological pathology were found to be greater among the alcoholics than among the controls. The authors contend that, unlike the use of diagnostic criteria, employing continuous measures of psychiatric symptomatology and psychological abnormality yields a much more accurate picture of co-occurring psychiatric illnesses among alcoholics.

(Fein, G, Di Sclafani, V, Finn, P, Scheiner, DL: Sub-diagnostic comorbidity in alcoholics. Drug and Alcohol Dependence 87:139-145, 2007.)

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