OBJECTIVE: Drawing on qualitative analysis of selected historical documents, the paper seeks to provide a definition of the general characteristics of the first institutional alcohol treatment facilities in today's Czech Republic and Slovakia, taking into account the historical context of the first half of the 20th century. An additional aim was to point out the importance of archival research and its contribution to understand the determinants of alcohol-related agenda and alcohol treatment. METHODS: The basic data platform was generated by analysis of historical documents pertaining to the subject matter under study and to institutional processes in different periods. The data was processed using the open coding method (as part of the grounded theory approach) and other specific methods based on the matching of data from scientific and professional literature and archives in different periods. Over 1,100 pages of text from relevant archival materials were analysed. This research is original, no such systematic analysis of historical documents on this subject matter has been conducted on such a scale with the intention of identifying the general correlates of the historical development of an alcohol-related agenda and alcohol treatment. RESULTS: The establishment of the first institutional facilities intended to provide treatment for alcohol dependency was based on the notion of addiction as a disease, which needs to be treated in dedicated facilities applying an individualised approach. The circumstances of the establishment of the facilities under analysis were similar. Their existence was made possible by distinguished personalities rather than a general belief and social pressure that the issue of alcohol addiction should be addressed. This also explains the fact that the occupancy of these facilities never reached their full capacity, that they were not self-reliant in economic terms, and that they did not readily resume their operation after 1945. CONCLUSIONS: The analysis of the establishment, operation, and dissolution of these facilities at the time reveals the discontinuity in the approach to alcohol abuse and its treatment in the context of the historical development and perception of alcohol-related problems in Czech and Slovak society in the first half of the 20th century. Significant social changes occurred after 1948. New legislative instruments were used to enforce treatment based on a principle that was different from the previous approaches. The results of our study also make it possible to reveal the intensity of apparent individual and institutional motives in the process of the development of alcohol treatment in historical terms and its projection into different post-war periods. The understanding of these correlates will help in designing additional trajectories of research into the effects of social and political changes on addiction treatment and thus identifying the intensity of the historical development and its influence on the perception of addiction treatment at present. These findings will also be of great importance for a historical comparative analysis, including overlaps with the development of recent theories, and will support the emergence of new areas of study for the social sciences.
- Klíčová slova
- Czech Republic, Slovak Republic, alcohol, institutional alcohol treatment,
- MeSH
- alkoholismus terapie MeSH
- centra pro terapii drogových závislostí dějiny MeSH
- dějiny 20. století MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- Check Tag
- dějiny 20. století MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
BACKGROUND: Poland, Czech Republic, and the Slovak Republic are countries with high alcohol consumption, and alcohol-induced disorders are in the ten leading causes of Years Lost due to Disability. Therefore it is necessary to study factors as insight, motivation, and readiness to change for the better understanding the variables which are in probably connected with therapeutic effectiveness. AIM: The purpose of the study was to examine the state of readiness to change at the beginning and the end of inpatient short (six weeks) and long (12 weeks) therapeutic program in the Slovak Republic, Poland, and the Czech Republic, and look for the relationship between readiness to change, insight, and motivation in alcohol-dependent persons. METHODS: We studied a sample of 380 alcohol-dependent inpatients (282 men and 98 women) by Alcohol Use Disorders Identification Test (AUDIT), The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Readiness to Change Questionnaire (RCQ), and Demographic Questionnaire. RESULTS: The unmarried patients declare a higher severity of alcohol dependence than married or divorced ones in AUDIT questionnaire. At the beginning of the treatment, the majority of patients declared Action (68.5%) or Preparation (26.3%) motivation stage according to RCQ questionnaire. At the end of the treatment, married patients showed higher readiness to change in domain Taking steps of SOCRATES questionnaire. The unmarried patients displayed the decrease of domain Ambivalence. The duration of the completed therapeutic program may not be crucial for improvement in preparedness to change. CONCLUSIONS: The intention and motivation to alcohol dependence treatment seem to be high at the beginning of the treatment, but recognition of the alcohol problems were low in highly dependent patients. Marital status was connected with an increased active component for readiness to change. The passive component (decreasing the ambivalence) was observed in the unmarried patients.
- MeSH
- alkoholismus psychologie terapie MeSH
- dospělí MeSH
- duševní poruchy komplikace MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- manželský stav MeSH
- motivace * MeSH
- neuropsychologické testy MeSH
- pacienti hospitalizovaní psychologie MeSH
- průzkumy a dotazníky MeSH
- socioekonomické faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Polsko MeSH
- Slovenská republika MeSH
A 62-year-old man with a history of chronic alcohol abuse presented with severe pancreatic panniculitis associated with an acute exacerbation of chronic pancreatitis.
- MeSH
- alkoholismus komplikace diagnóza terapie MeSH
- dermatózy dolních končetin komplikace diagnóza terapie MeSH
- diferenciální diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- pankreatitida komplikace diagnóza terapie MeSH
- panniculitis komplikace diagnóza terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
The recovery of a male health professional dependent on alcohol and other psychoactive substances was possible only after long-term cooperation with the organization Alcoholics Anonymous. This case report illustrates the principle that addiction is a chronic disease and its treatment is successful if it is treated as a chronic disease.
OBJECTIVES: The acute and maintenance treatment of alcohol addiction represents the clinical challenge. The aims of our study were to evaluate the influence of alcohol consumption on regional brain metabolism and the predictive value of PET by means of the duration and quality of remission which followed the sub-acute treatment. METHODS: PET investigation with 18 fluoro-deoxyglucose (18FDG) were performed in detoxified patients with alcohol dependence at the end of short-term treatment. Abstinence was evaluated in patients during the one year follow-up period. RESULTS: We detected the positive correlation between 18FDG uptake in the cerebellar vermis (FWE, p<0.05) and duration of abstinence within one year. DISCUSSION: Our findings support the assumption that the cerebellum would be involved in the maintenance of abstinence in alcohol dependent subjects. Cerebellar connections with cortical areas critical for addiction such as frontal, parietal, temporal regions would mediate the influence of the cerebellum on emotional systems related to addiction. CONCLUSIONS: Our study is the first to document that the cerebellum and particularly the vermis is involved in the clinical outcome in terms of abstinence during one year. Our findings support the role of the cerebellum in addiction and the possibility to predict therapeutic outcome.
- MeSH
- alkoholismus metabolismus terapie MeSH
- časové faktory MeSH
- dospělí MeSH
- fluorodeoxyglukosa F18 metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mozeček diagnostické zobrazování metabolismus MeSH
- pití alkoholu metabolismus MeSH
- pozitronová emisní tomografie metody MeSH
- radiofarmaka metabolismus MeSH
- terapie neúspěšná MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- fluorodeoxyglukosa F18 MeSH
- radiofarmaka MeSH
During 1994 to 2003 the number of patients treated in the Psychiatric Centre Bohnice who had within the first three dismissory diagnosis alcohol related disorders increased by 77% and disorders caused by other psychoactive drugs increased more than four times. An increase was observed also in pathological gambling (37%). In alcohol related problems the highest increase was seen in drug cessation (about four times). In other drug related problems the highest increase was marked in addiction treatment (almost five times). Such trend probably reflects the situation in the society together with other effects described in the study.
Brief intervention for alcohol related problems is effective. Considering high per capita alcohol consumption, it is desirable that brief intervention should be practiced not only by health professionals but also by other workers. Feedback about alcohol related problems, clear advice, motivation enhancement, written texts, active referral, etc. has been used. Screening and brief interventions were successfully employed in general practice, psychiatry, gynaecology and obstetrics, at emergency and trauma units, in judiciary system, at schools including colleges and at various workplaces.
- MeSH
- alkoholismus diagnóza terapie MeSH
- lidé MeSH
- poradenství * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
We summarize specific features of alcohol-related problems in elderly patients. About one third alcohol dependent elderly patients develop their alcohol dependence while already aged. It often happens after stressful life events such as retirement or bereavement. Such patients can be treated more easily and alcohol does not cause so many somatic complications in them when compared with those elderly who develop their dependence earlier. Alcohol-related problems in elderly patients should be recognized and treated as soon as possible. Cognitive-behavioural therapy, supportive group therapy with peers (especially in lonely patients), self-help groups, such as Alcoholics Anonymous, and family therapy are appropriate. Modern anticraving medication can be also effective but comparatively high price limits its use.
- MeSH
- alkoholismus * prevence a kontrola psychologie terapie MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
The research deals with patients dependent on alcohol (F 10.2) who were treated on a voluntary basis by psychotherapeutic and sociotherapeutic methods in seven hospitals. For ethical, legal as well as professional reasons it was impossible to form a control group. Sixty six patients (28 women, 38 men) were put to the Regensburg inventory analysis of incongruities, its statistical evaluation was done by SPSS. The aim of the research was to detect personally changes in patients induced most probably by their hospital stay. As statistically significant (t-test, u-test, alpha adjustment, effect size), we detected positive changes in the following personality variables: the patient's self-confidence (p < 0.001, ES = 1.11), favourable self concept including the ability to tolerate and manage their inner incongruities (p < 0.001, ES = 0.48), an increase of self-congruent experiences (p < 0.001, ES = 0.45) and a decrease of insufficiency feelings (p < 0.001, ES = 0.40). We consider our findings as preliminary and it is necessary to prove them by further research.
- MeSH
- alkoholismus prevence a kontrola terapie MeSH
- lidé MeSH
- poruchy spojené s užíváním psychoaktivních látek prevence a kontrola terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Spojené státy americké MeSH
