Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.
National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence.
A history of suicide attempts was reported by 29.2% at t1, and suicidal ideas by 14.1% and suicide attempts by 5.4% at the follow-up (t2). One female patient committed suicide within 6 months of discharge from hospital. The following co-morbidity patterns were associated with the greatest risk for suicidal ideas. Anxiety and depressive disorders, Axes I and 11 disorders, and a history of suicide attempt (for suicidal ideas at (t2). CONCLUSION. Our results underline the importance of psychiatric co-morbidity for the suicidal risk in alcohol-dependent patients, while alcoholism itself appears to be only a moderate risk factor.
Due to low comorbidity rates, subclinical OCD seems to represent an independent syndrome not restricted to the presence of other axis-I diagnoses. Comorbidity patterns show a disposition to anxiety and to depressive disorders in OCD and subclinical OCD. A broad association with obsessive-compulsive spectrum disorders could not be confirmed in our general population sample.
The entire spectrum of personality pathology should be assessed in the comorbidity research of alcoholism. The two types of alcoholism differ on a variety of alcohol-related and comorbid personality characteristics, but further research is needed to clarify the underlying psychological and biological associations.
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