A multicentric Indian cross-sectional study on medical and psychiatric comorbidities among patients with alcohol dependence

Alcohol dependence is often associated with various medical and psychiatric conditions, that influence overall treatment outcomes. Available evidence largely comes from single-centre epidemiological studies with no comprehensive data on comorbidity patterns among treatment-seeking populations. To examine proportion and patterns of medical and psychiatric comorbidities among treatment-seeking patients with alcohol dependence across multiple centres in India, and to evaluate variations across centres. This multicentric, cross-sectional observational study was conducted across 16 institutes in India from December 2023 to December 2024. Adults aged 18 years and above, diagnosed with alcohol dependence according to ICD-11 were included using purposive sampling. Structured checklist and Charlson Comorbidity Index were used to document medical comorbidities. Psychiatric comorbidities were documented based on routine clinical diagnostic interviews based on ICD-11. A total of 1850 patients were enrolled in the study with mean age of 39.6 years and male predominance (98.5%). At least one medical comorbidity was present in 48.1% of patients, most common being acid peptic disease (26%), followed by hypertension (12.1%). At least one psychiatric diagnosis apart from substance dependence was present in 23.0% of the participants. The common psychiatric comorbidities included single-episode major depressive disorder (4.1%), personality disorder (3.3%), and generalized anxiety disorder (2.9%). Notable regional variations in comorbidity patterns were observed. This large-scale multi-centre study reveals a considerable proportion of patients having medical and psychiatric comorbidity. Also, variations in comorbidities exist across the treatment settings, which may be attributable to population, provider, or treatment setting characteristics.