Olga McGowan
Currently I am ST6 General Adult Psychiatry Trainee in West of Scotland, NHS Greater Glasgow and Clyde.
I have graduated Medical University in Ukraine, Kyiv. After working several years in Neurology Department, I have done PhD in Neuropharmacology and had Post Doc post for 1 year in Queen’s University Belfast investigating the pharmacogenetics of antipsychotic and antidepressant drug action (Yevtushenko et al, 2008). I was also involved in pharmacogenetic research of investigating response to treatment of panic disorder with selective serotonin reuptake inhibitors (Yevtushenko et al, 2010).
As part of my Higher training in Psychiatry I did endorsement in Addictions Psychiatry last year and as part of my scientific interest I took part in the research project “Alcohol Related Brain Damage in the over 65’s Reliability of the diagnosis and outcomes over time”, which I am presenting as a poster at SSA Annual Conference.
Alcohol related brain damage in the over 65s: Reliability of the diagnosis and outcomes over time
Aim and hypothesis: We were aware from previous work that an apparent recent rise in ARBD (alcohol related brain damage) discharges from acute hospitals in NHS GGC, between 2000 and 2010, was driven by an increase in the over 65 age group. We aimed therefore to look at a sample of these patients from a single year (2010) to check on diagnostic accuracy and to look at outcomes over five years.
Methods: We created a linked data set in Safehaven using a cohort of 66 patients over 65 years in 2010 with an SMR 01 diagnosis of alcohol amnesic syndrome, Wernicke’s encephalopathy and/or alcohol dementia. The 66 patients generated 142 discharges in 2010. We looked at those over 65 years within this cohort and applied Oslin’s criteria to identify probable ARBD excluding head injury and stroke. We followed each patient’s journey from 2010 to 2015 to see if the initial diagnosis of ARBD was supported. We then looked back into data prior to 2010 to find earliest date of diagnosis of ARBD and earliest date of neuro-imaging to give further information around diagnosis.
Results: The most striking results are the very high death rate in this patient group after five years (68%) and the level of multiple morbidity that this reveals. In around two thirds of patients neuroimaging is available and we summarise these findings alongside an analysis of the likely validity of the diagnoses. Our findings caution against thinking of changing discharge statistics for ARBD cases as necessarily reflective of incidence of the condition as around half of our cases had a pre-existing diagnosis and many were being readmitted for incidental reasons such as respiratory infection.
Conclusions: One starting point for our interest in this topic is the literature on ARBD as a possible precursor to later dementia. We discuss our findings within the context of a summary of this literature. Our findings have implications for service provision in relation to ARBD/ARBI given that some ARBD services have a notional cut-off at age 65 years with patients over that age being cared for by psychiatry of old age services.
Poster link: Alcohol related brain damage in the over 65s: Reliability of the diagnosis and outcomes over time