Date of Award

1987

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Abstract

This study was concerned with the extent to which the abuse of alcoholic beverages is associated with the frequency of use of physicians in Canadian family practice and the type of morbidity presented to the doctor. The study group was composed of 108 problem drinkers identified in two family medical practices in London, Ontario. The utilization of their family physician was compared to a matched control group over a two-year period. Utilization by the spouses and children living with the problem drinkers was also examined. Data were obtained retrospectively from a problem oriented, patient classification system and other aspects of the medical records. The main dependent variables were the average number of patient-physician contacts per year and the type of diagnoses made during each contact.;The results showed that problem drinkers were in contact with their family physician twice as often as matched control patients. They were also more likely to be diagnosed as having neoplastic disease, endocrine/nutrition disorders, mental health problems, drug or tobacco abuse, respiratory, digestive and skin disease, vague signs, symptoms and ill-defined conditions, traumatic injuries and social/marital/family problems. The higher rate of utilization was due primarily to the higher prevalence of psychosocial problems and traumatic injuries.;Spouses of the problem drinkers did not differ significantly from their matched controls on the frequency of utilization, although visits were more common for mental health problems and problems associated with social/marital/family relationships. No differences in utilization emerged when the overall sample of children of problem drinkers was compared to their control group. However, index children between the ages of six and eleven were more frequent attenders and had more psychosocial problems.;The findings of this investigation are discussed in terms of the development of case finding procedures to detect familial alcohol abuse and the planning of future studies into the efficacy of therapeutic interventions with these families.

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