Assessing financial status, legal status, employment status and social relationships in patients with complicated and uncomplicated alcohol withdrawal.

INTRODUCTION: Alcohol dependence is a prevalent health problem in India with 12-month prevalence of 2.1%. Patients with alcohol withdrawal can present with symptoms ranging from mild to severe withdrawals including withdrawal seizures and delirium tremens with significant mortality. Thus it will be beneficial to identify patients at risk for severe withdrawals for appropriate management. Previous studies have correlated drinking pattern with withdrawal severity but there are limited studies comparing social factors to the severity of withdrawal symptoms. Studies correlating age with withdrawal severity showed conflicting results- with one study showing higher severity and prolonged withdrawals in younger patients while another study showing more severity in older patients. In another study bivariate analysis showed patients who were African-American, unemployed, and homeless were more likely to develop delirium tremens. Thus we propose this study to assess financial status, legal status, employment status and social relationships in patients with complicated and uncomplicated alcohol withdrawal. AIM: To assess financial status, legal status, employment status and social relationships in patients with complicated and uncomplicated alcohol withdrawal. METHODOLOGY: STUDY DESIGN: hospital-based cross-sectional study. UNIVERSE OF STUDY: All adult patients admitted to any psychiatry unit for acute management of alcohol withdrawal. STUDY POPULATION: Adult patients admitted to Department of Psychiatry and Drug De-addiction Centre, Lady Hardinge Medical College & Smt. S. K. Hospital, New Delhi for acute management of alcohol withdrawal. Study population comprised of three groups- 1. Patients with Alcohol withdrawal seizures (AWS) 2. Patients with Alcohol withdrawal delirium tremens (AWDT) 3. Patients with alcohol withdrawal uncomplicated (AWU) STUDY DURATION: 18 Months (November 2017 to April 2019) Data collection period: 12 months (November 2017 to December 2018) During the study period, all adult patients admitted for acute management of alcohol withdrawal were assessed for inclusion in study. Those fulfilling selection criteria and willing to give consent were recruited in the study. Participants were recruited only after they were conscious, oriented and had minimal alcohol withdrawal signs/symptoms (CIWAAr <10) to ensure that they are amenable for interview. Patients were assessed for various risk factors, the social factors concerned with this study were assessed using Alcohol severity Index(ASI). Alcohol Severity Index(ASI) assessed drug and alcohol use, psychiatry and medical comorbidity and effect of alcohol use on their medical status, employment status, legal status and family relationship. RESULTS AND CONCLUSION: The following study reveals significant differences in the legal status, financial status, employment status and social relationships among patients of complicated and uncomplicated alcohol withdrawal. However, within the two groups of complicated alcohol withdrawal, that is, alcohol withdrawal delirium tremens (AWDT) and alcohol withdrawal seizures (AWS) there were not much significant differences in the given domains assessed. The data is large and detailed results along with conclusion will be part of final presentation.