알코올중독자의 병식 수준과 심리적 특성의 관계

Relationship between Insight Level and Psychological Characteristics in Alcoholic Patients

Objectives：When we treat alcoholism, we frequently meet the alcoholic patients’ defense mechanism such as denial, minimization, projection, rationalization and so on. For successful recovery, alcoholic patients must have the true insight. But most alcoholic patients rarely have it. This study was intended to investigate the relationship between insight level and psychological characteristics in alcoholic patients. Method：The subjects participated in this study were 147 alcoholic patients who were diagnosed as alcohol dependence by DSM-IV and NAST and were admitted to Dasarang Alcohol Hospital, Kwang-ju between April and October, 2001. The subjects were divided into three groups according to insight level. Subjects were surveyed by questionnaire about the sociodemographic data, clinical data, HAIS, alcohol problem scale, self-esteem scale, social support scale, BDI and STAI. Results：Among 147 subjects, 33 (22.4%) were ‘good insight group’, 73 (49.7%) were ‘fair insight group’, 41 (27.9%) were ‘poor insight group’. This study showed the group of lower insight level was the older alcoholic patients. Insight level was higher when the patients’ admission type was voluntary, when alcoholic patients had admitted in the department of internal medicine because of alcohol related physical illness and when frequency of admission was high. Both Lower BDI score and absence of current physical illness were shown in the groups who were higher insight level. The ‘poor insight group’ was shown the highest BDI and STAI scores and the lowest social support scores. Hierarchical multiple regression, which considered sociodemographic, clinical and psychological variables simultaneously, showed that the insight of alcoholics was significantly predicted from frequency of admission, occupational-social problem, age, education and behavior problem. Conclusion：If the insight level is lower, the alcoholic will be more depressed and anxious. To increase the alcoholic patients’ insight, 1) it is effective for them to confront their own occupational-social and behavior problem. 2) we should help alcoholic patients enter to therapy when alcohol problem occur. The sooner, the better.