Perceived health status, alcohol-related problems, and readiness to change among medically hospitalized, alcohol-dependent patients

Objective: Alcohol dependence is prevalent among medically hospitalized patients, and acute illness has the potential to increase motivation to change and provide a therapeutic window for treatment of alcohol dependence. This study evaluated the correlations of readiness to change drinking behavior with perceived physical and mental health status and specific alcohol-related consequences of medical inpatients. Design and measurements: The study was a cross-sectional survey of 50 clinically recognized and subsequently confirmed alcohol-dependent patients admitted to general internal medicine teaching services with no evidence of chronic cognitive functional deficits. We estimated correlations of process-of-change variables (problem recognition, ambivalence about change, and taking steps to change drinking) with measures of patient perception of general physical and mental health status and self-reported alcohol-related consequences. Results: Problem recognition (r= -0.31, P=.028) and ambivalence about change (r= -0.41, P= .003), but not taking steps to change drinking (r = -0.26, P = .072) were significantly associated with perceived physical health. Perceived mental health was not associated with these variables, but greater alcohol-specific consequences were typically associated with greater recognition, ambivalence, and intent to change. Conclusions: Among alcohol-dependent patients with acute medical illness requiring hospitalization, poorer perceived health status was associated with increased recognition of drinking problems and thoughts about changing drinking behavior. Future research should evaluate if problem recognition and ambivalence modify treatment involvement and outcomes following hospitalization and if hospital-based interventions designed to link medical conditions and their treatment to alcohol dependence enhance recognition and ambivalence.