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Dependenta de alcool

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  • Pentru ca unul din cele mai frecvente simptome ale alcoolismului este negarea, diagnosticarea alcoolismului poate fi dificila si depinde de sinceritatea individului de a raspunde la intrebari legate de consumul sau de alcool. De cele mai multe ori membrii familiei si prietenii apropiati constata aceasta problema cu mult inainte ca aceast diagnostic sa fie pus in urma unei evaluari de specialitate.

    De multe ori consumul de alcool nu este diagnosticat in urma unor controale medicale de rutina sau chiar in timpul spitalizarilor. In general sub 30% din pacienti sunt diagnosticati ca alcoolici in acest fel. De cele mai multe ori medicii nu recunosc simptomele dependentei de alcool si chiar si atunci cand o fac sunt refractari la a comunica pacientilor acest lucru. Prin natura meseriei, ei se preocupa de tratarea unor afectiuni organice ale bolnavului care insa de multe ori se datoreaza de fapt abuzului de alcool.

    Pe pacursul timpului s-au dezvoltat mai multe teste de evaluare a problemelor legate de consumul de alcool. Pentru ca asa cum aratam, negarea este o problema, cele mai multe dintre teste nu cer un raspuns direct despre cat de mult bea persoana, punand insa intrebari despre probleme asociate consumului de alcool.

    Exista sute de teste disponibile, inclusiv multe examinari detaliate cu zeci de intrebari. In ultimii ani insa au fost dezvoltate teste scurte formate din cateva intrebari (4-5) foarte utile in depistarea problemelor legate de consumul de alcool in cabinetele medicale si centrele de asistenta sanitara primara. Testele cu seturi mai lungi de intrebari se utilizeaza de regula pentru evaluarea mai avansata a stadiului de evolutie a dependentei de alcool.

    Cele mai multe metode de evaluare au un anumit grad de eroare si este important sa fim constienti ca unii pacienti ce par pozitivi pot sa nu fie bautori cu probleme.

    Precizia si exactitatea metodelor de evaluare este masuarata si comparata īn termeni de sensibilitate si specificitate.

  • Sensibilitatea (precizia) masuratorii reprezinta capacitatea instumentului de evaluare de a identifica bautorii abuzivi sau dependenti la nivelul populatiei. Spre exemplu, daca un test are precizia de 96% inseamna ca este capabil sa identifice 96% din subiectii evaluati.
  • Specificitatea masuratorii reprezinta capacitatea instumentului de evaluare de a identifica in mod corect care sunt bautorii abuzivi sau dependenti. Spre exemplu, daca un test are specificitatea de 85% inseamna ca testul va evalua gresit 15% din subiectii evaluati.
    Cele mai exacte instrumente de evaluare au atāt sensibilitatea cat si specificitatea ridicata.

    Prezentam cateva din cele mai cunoscute si utilizate teste de evluare a dependentei de alcool precum si un test de evaluare a comportamentului co-dependent.


    Teste scurte pentru depistarea problemelor

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    Teste lungi pentru evaluarea gradului de dependenta

    Testul AUDIT

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    Teste pentru evaluarea co-dependentei

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  • Alcohol addiction can be difficult to diagnose especially when the individual is not honest when inquired about their abusive use of alcohol. Most alcoholics display a very common addiction symptom called denial, therefore in most situations family members and friends are the first to become aware of their alcohol problem.

    Unfortunately, the disorder can go undiagnosed during regular medical check-ups or when the person is hospitalized because the medical staff does not recognize the alcohol addiction symptoms or they are reluctant in communicating the diagnosis to the patient. Most doctors or specialists are concerned with treating the physical symptoms rather than addressing the real cause of the problem (the abusive use of alcohol). Only a small percentage of patients (30 percent) are diagnosed as alcoholics in general practitioner offices.

    Although alcohol addiction has only recently attracted a reduce interest among some of the Romanian mental health specialists, the international literature provides an abundance of information regarding the addiction and assessment tools that are useful in diagnosing the addiction. Most of the screening tests used in the diagnosis process focus on determining the severity of the problems associated to the abusive use of alcohol rather than inquiring the exact amount of alcohol consumed.

    There are numerous screening tests available for the use of mental health specialists, addiction counselors, and general practitioners. Some of these tests are designed as extensive questionnaires with multiple statements used in extensive, detailed evaluations of the addiction, some as brief tests (4-5 items) available for general practitioners.

    The increased number of screening tests designed to assess a person's alcohol problem, raises the question of how valid and reliable these assessment instruments are in detecting the presence of the condition. The two most used psychometric properties in establishing the reliability of an assessment instrument are sensitivity and specificity.

  • Sensitivity represents how well the test finds that someone with a disease indeed has it. If a test claims to have a 96 percent sensitivity in detecting a condition, then the test should identify 96 percent of the assessed subject that have the condition.
  • Specificity represents how much the test results depend on the presence or absence of the condition/disease. In ideally conditions, those individuals that don't have the condition should test negative for it.

  • Although no test is 100% reliable, it should exhibit high levels of sensitivity and specificity.

    For those interested, in this section of the website we included some of the most known and used alcohol addiction screening tests and a questionnaire that evaluates the codependent behavior.


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