Social Factors in the Diagnosis of Alcoholism. I. Characteristics of the Patient

Publisher Website
Google Scholar
Abstract
The relationship between physicians'' attitudes and action diagnosis or nondiagnosis formed the focus of this study. Two groups of male alcoholics admitted to a hospital emergency ward over a 10 month period were compared: (1) 200 alcoholics assigned by the emergency ward chief medical officers to an experimental project for treatment of alcoholism; (2) 238 alcoholics not assigned to the project but meeting criteria for diagnosis of alcoholism. We reasoned that assignment or nonassignment of alcoholics to the project varied systematically with (1) physicians'' attitudes about alcoholism, i.e., that physicians perceive alcoholism as a disorder occurring primarily among derelicts; and (2) their attitudes about medical diagnosis, i.e., that physicians prefer a medical diagnosis to one that includes social and psychological malfunction. Two hypotheses were tested: (1) nonassigned (missed) patients show a lower incidence than assigned patients of social characteristics associated with the alcoholic as derelict; (2) nonassigned patients show a higher incidence than assigned patients of characteristics relevant to the physician''s tendency to classify patients according to basic organic or body-system disorders. The first hypothesis was supported by the differences found between the assigned and missed groups on 7 social variables. The second hypothesis was supported by differences found on five medically relevant variables. On a scale of social integration, constructed from the 7 social variables, the percentage distribution of the 2 groups differed significantly. On a five-point medical index, the percentage distribution of the 2 groups differed significantly. On a combined social and medical index the percentage distributions differed significantly. The findings are discussed in terms of medical attitudes toward alcoholism and the implications for case finding, prevention and treatment.

This publication has 3 references indexed in Scilit: