Quality of life in wives of alcohol dependence syndrome patients

 

Sudhir J Gaikwad¹, Sagar Kulkarni^2*, Vaibhav Chaturvedi³

 

 

Abstract               Background: Alcoholism causes harm to the well-being and health of the person and also the family. Spouses are mostly affected because of the intimate nature of the relationship. Traditionally most of the studies have focused only on the individual consuming alcohol. Aim and Objective: To study the various factors that affect quality of life in wives of alcohol dependence syndrome patients. Methodology: Total 80 wives were selected after applying inclusion criteria. Sociodemographic data was collected by interviewing them. QOL score was calculated by using WHO-QOL-BREF scale. Result: A significant correlation was seen between poor quality of life among wives and severity of alcohol addiction among husbands across all domains of QOL (p<0.05). Similarly negative correlation was also observed with duration of alcohol consumption, though it was significant only in social and psychological domain (p<0.05).

Key Words: Quality of life.

 

 

INTRODUCTION

A total of 33% Indian population consumes alcohol (second largest in the world) and 20% of disability-adjusted life years are lost because of poor health status, marked nutritional deficiencies and high prevalence of alcohol addiction^1,2. Alcoholism causes harm to the well-being and health of the person and also the family. Spouses are mostly affected because of the intimate nature of the relationship. Traditionally most of the studies have focused only on the individual consuming alcohol. Even though few data has been reported in public media, studies on the impact on spouses have been very few in psychiatric literature. Clinicians started recognizing from 1970s that the psychological problems of caregivers were not as a result of their own pathology but as a consequence of chronic stress³. Depressive symptoms lead to a state of social withdrawal which in turn leads to feelings of anxiety, despair and powerlessness and continues as a vicious cycle. Several studies have shown significant correlation between alcohol use in husband and suicidal tendency in spouses. Causes for high rates of suicide in married women included suspicion by husband, domestic violence and poverty⁴. There is increased incidence of somatization, interpersonal sensitivity and hostility in spouses of alcoholic men especially when associated with battering by spouses⁵. Stress of living with an alcoholic was responsible for the personality deficits in women⁶. Studies done on the personality deficits of spouses of alcoholics showed that they were less extroverted than wives of non-alcoholics and found them to be silent, eccentric and group dependent^7,8. Research has shown the association of alcoholism with variations in the quality and outcomes of marital relationship⁹. Quality of the marital life can be inversely related to the psychological distress. A study done to assess the interaction pattern in families with alcoholic husband has shown poorer pattern in the domains of reinforcement, social support, role, communication and leadership¹⁰. Domestic violence and an exacerbation of poverty have made alcohol abuse the single most important problem for women in India.

 

MATERIALS AND METHODS

Type of Study: Hospital based Case Control study

Study Area: Departments of Psychiatry, Bharati Vidyapeeth (Deemed to be) University Medical College and Hospital, Sangli

Study Duration: Jan 2016 to June 2017 (1.5 years)

Study Population: Sample size was=80, Wives of alcoholic dependent patients=40, Wives of persons who do not consume alcohol=40

Inclusion Criteria

• Age-18 to 59 years females.
• Education-5^th standard and above
• Wives of Alcohol Dependence Syndrome patients (using ICD 10 criteria) attending OPD and Alcohol Dependence Syndrome patients admitted in Psychiatry and Medicine ward of Bharati Hospital
• Wives of persons who do not consume alcohol.

Exclusion Criteria

• Wives who are suffering from chronic physical and psychiatric problems.
• Wives who consumes alcohol.
• Wives of husband who are suffering from Psychiatric disorders except Alcohol Dependence Syndrome.
• Wives of patients who is suffering from major chronic diseases like tuberculosis, leprosy, cancer etc. or which can effect Quality of life of their Wives.
• Wives who are suffering from psychiatric illness.

Instruments used in the Study

• WHO QOL- BREF Scale – To assess the quality of life.
• Alcohol Dependence Data Questionnaire (SADD) – To assess the severity of Alcohol addiction.

Methodology

The Alcohol Dependence Syndrome patients was diagnosed by using ICD-10 criteria. These patients are not having any other psychiatric disorder and were under treatment as outpatient or inpatient for Alcohol Dependence. All the subjects recruited for the research underwent following:

• Details of the study protocol was explained to the subjects.
• Informed consent was obtained.
• Detailed history was taken including demographic details and details regarding alcohol consumption.
• Then the Alcohol Dependence Syndrome patients were given Short Alcohol Dependent Data Questionnaire (SADD) containing 15 questions having 4 options and assess severity of Alcohol Dependence.
• WHOQOL BREF Questionnaire, containing of 26 questions were administered to Wives of Alcohol Dependence Syndrome patients in presence of female attendant(female nursing staff working in psychiatry) working in psychiatry, to measure 4 domains:
• Physical Health
• Psychological Health
• Social Relationship
• Environment

Statistical Analysis: Data were statistically described in terms of mean (±SD), frequencies (number of cases) and percentages when appropriate. The Mean Scores obtained from wives of alcohol dependence syndrome patients was compared with the mean data obtained from the Control Group, using Mann Whitney U test. Severity of alcohol Dependence was correlate with QOL score of their Wives using spearman’s correlation. Qualitative data was compared using chi-square tests. A probability value (p value) less than 0.05 was considered statistically significant. All statistical calculations were done using computer programs Microsoft Excel 2007 (Microsoft Corporation, NY, USA) and SPSS (Statistical Package for the Social Science; SPSS Inc., IBM) version 22.

RESULT

 

Table 1: Age comparison of wives of alcohol dependence syndrome patients and wives of person who do not consume alcohol-

 

On comparing the age of wives of alcohol dependence syndrome patients and wives of person who do not consume alcohol, present study observed no significant difference (p value 0.34). About half of the females were between 21-40 years of age in both groups.

Table 2: Comparison of Quality of life among wives of alcoholic and non –alcoholic husbands

Poor Quality of life was seen in 90% of the females with alcoholic husband as compared to 50% with non-alcoholic husband (p<0.01).

 

Table 3: Comparison of Mean Quality of life among wives of alcohol dependence syndrome patients and wives of person who do not consume alcohol

Quality of life comparison between wives of alcoholic and non–alcoholic husbands was made using WHO-QOL-BREF. Wives of alcoholic husbands showed poor quality of life in all domains i.e. physical, psychological, social and environmental (p<0.01).

Table 4: Correlation of quality of life parameters among wives with severity of alcohol dependence and duration of alcohol consumption among husbands-

Spearman correlation
WHO QOL-BREF (Wife)	SADD Score		Duration of Alcoholism
	r-value	p- value	r-value	p- value
Physical	-0.44	<0.01	-0.17	0.083
Psychological	-0.61	<0.01	-0.21	0.036
Social	-0.39	<0.01	-0.25	0.01
Environmental	-0.24	0.014	-0.18	0.08

A significant correlation was seen between poor quality of life among wives and severity of alcohol addiction among husbands across all domains of QOL (p<0.05). Similarly negative correlation was also observed with duration of alcohol consumption, though it was significant only in social and psychological domain (p<0.05).

 

DISCUSSION

Quality of Life of Wives: Quality of life comparison between wives of alcohol dependence syndrome patients with Wives of persons who do not consume alcohol was made using WHO-QOL-BREF. Poor Quality of life was seen in 90% of the females with alcoholic husband as compared to 50% with non-alcoholic husband (p<0.01).Wives of alcohol dependence syndrome patients showed poor quality of life in all domains i.e. physical, psychological, social and environmental (p<0.01). In a study by Sharon P et al.¹¹, majority (66.7%) of the wives of alcohol dependence syndrome patients report that they have low level of perceived quality of life whereas, majority (66%) of the wives of persons who do not consume alcohol report that they have high level of perceived quality of life. Dawson et al.¹² observe the mean psychological and physical quality-of-life scores in wives of alcohol dependent patients to be lower by 11% and 5% than wives of persons who do not consume alcohol. Gohil G et al.¹³ in their study observed that quality of life was significantly poor among caregivers of alcohol dependent patients. Sharma et al.¹⁴ in their study aimed to investigate the problems faced and coping strategies used by the wives of alcohol dependence patients. The findings revealed the problems faced by wives of alcohol dependent patients were in multiple domains viz. physical, psychological and social. Thus observations made by present study and that by other author’s revealed poorer quality of life among the wives of persons with alcohol dependence.

Predictors of Poor Quality of Life: In present study, a significant correlation was seen between poor quality of life among wives and severity of alcohol dependence among their husbands across all domains of QOL (p<0.05).We also observed a negative correlation between duration of alcohol consumption and quality of life of wives, though it was non-significant apart from psychological domain (p<0.05). Stewart et al.¹⁵ explored the relationship between drinking intensity and quality of life and observed that drinks per day i.e. severity of alcohol dependence exerts a greater influence on quality of life in women than duration. Western studies have found a correlation between duration of alcohol dependence and marital discord¹⁶, while one Indian study had found a positive correlation between duration of dependence in men and higher levels of distress in their wives¹⁷. This however, was not replicated in the present study. We thus observed that quality of life in wives of alcohol dependence syndrome patients were significantly lower than their wives of persons who do not consume alcohol. The poor quality was reflected in all domains of life i.e. physical, psychological, social and environmental and was associated with severity of alcohol dependence in husbands.

 

 

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