Five-year outcomes of a brief alcohol intervention for adult in-patients with psychiatric disorders

Aims To compare 5 year outcomes (general hospital and mental health morbidity and mortality) among general hospital psychiatric in-patients randomized to receive either an alcohol reduction motivational interview (MI) or information pack (IP), and compare these to matched controls. Design We recruited 120 patients aged 18-64 years who scored greater than or equal to8 on the Alcohol Use Disorders Identification Test (AUDIT). We selected matched controls from in-patients not recruited but who reached the same AUDIT threshold. At 5 years, follow-up data were collected via a state-wide hospital record system. Findings There were no significant differences between the MI and IP groups in terms of 'survival' to their first alcohol-related, other general hospital or mental health admission over 5 years. Matched controls had significantly more mental health in-patient episodes (F[1,226] 4.4, P<0.05) and greater length of hospital stay (F[1, 226] 4.8, P<0.05) than the combined MI-IP group. Furthermore, the MI-IP group had longer 'survival' times to both first general hospital (mean 583 versus 392 days) and mental health in-patient (mean 788 versus 580 days) events. Collapsed across groups, dependent and harmful consumers had shorter 'survival' times than hazardous consumers (AUDIT classifications). Conclusions Alcohol interventions have medium-term health benefits for those with mental health and alcohol use problems. Importantly, there were no differences in outcome between the intervention groups. The low cost of providing an IP makes it attractive as an alcohol intervention. The AUDIT provided an effective means of identifying those who are at risk of subsequent alcohol-related admissions and may benefit from intervention.