Citation

Poser W, Poser S, Thaden A, Eva-Condemarin P, Dickmann U, Stötzer A. Suchtgefahren 1990; 36(5): 319-331.

Copyright

(Copyright © 1990)

DOI

unavailable

PMID

unavailable

Abstract

A longitudinal cohort study of patients with a psychoactive substance use disorder (PSUD, lifetime diagnosis) was started in Lower Southern Saxony (Federal Republic of Germany) in 1974. Patients from 2 hospitals (Psychiatric and Neurological Departments of the University of Gottingen) were recruited. Until 1989 2079 cases of abuse or dependence (definition according to DSM-III) had been collected. Mean time under observation was 5.8 ± 5.2 years. 447 patients used legal drugs only (abuse or dependence), 671 legal drugs plus alcohol and 245 legal plus illegal drugs. 671 patients suffering from alcoholism without use of other addictive substances served controls. Survival was analyzed by the indirect method and compared with expected survival (adjusted to age and sex) of the normal population of the FRG. Standardized mortality ratios (SMR) were calculated with their 95%-confidence intervals. 224 deaths occured during the follow-up period, 162 more than expected. Mortality was increased in all forms of PSUD: legal drugs SMR 2.1, legal drugs plus alcohol SMR 3.3, legal and illegal drugs SMR 16.7, alcoholism SMR 4.3. Dependence (SMR 3.8) was more dangerous than abuse (SMR 1.8). In patients who reached abstinence or had only short relapses the course was much more favorable (SMR 1.8) compared to those with unchanged (SMR 5.8) or worsened course (SMR 14.8). Women did better than men, but this was caused by an accumulation of cases with unfavorable prognosis (illegal drugs or alcoholism) among men. Within one form of PSUD (e.g. alcoholism) there was no difference between the sexes. In all types of PSUD suicides and accidents were frequent causes of death. Besides this alcoholics often died from hepatic cirrhosis or malignomas, patients on illegal drugs from infections. Death during withdrawal was a rare event.

Language: de

Keywords

adult; human; suicide; survival; alcoholism; mortality; drug abuse; article; major clinical study; fatality