飲酒問題：一個新展現的心理衛生問題

ALCOHOLISM: AN EMERGING MENTAL HEALTH PROBLEM IN TAIWAN

在1940年代的台灣精神醫學流行病學研究，發現嚴重飲酒問題之盛行率，在漢人是0.001%，在山胞是0.1%。那時，精神醫學的臨床工作，極少發現飲酒問題之個案。1980年代，以中文版之診斷問卷為個案標認工具，進行台灣地區漢人之精神疾病盛行率研究，發現大都市、鎮、鄉之酒濫飲與酒癮終生盛行率分別是3.4%，1.5%；8.0%，1.8%與6.3%，1.2%。在泰雅族、排灣族與雅美族山胞則發現酒濫飮與酒癮之終年盛行率分別是11.6%，11.4%；14.2%，9.0%與8.1%，6.4%。此外，目前精神科醫院住院病患中一直有為數不等之飲酒問題患者，可以說是不少見的。在綜合醫院裡非精神科病患中飲酒問題者之盛行率亦不可忽略。目前台灣到處可見啤酒屋、酒吧；社交宴會中亦有強烈之勸酒、猜拳以行樂。人們常以酒量大而受人恭維或讚賞；大眾傳播也時時有酒後暴行傷人、車禍意外等報導。凡此種種資料強烈提示台灣地區飲酒問題在過去40年來有明顯之增加，值得心理衛生界、一般衛生界與社會政策決策者之重視。

The prevalence rate of alcoholism was only 0.01% in Taiwan Chinese and 0.1% in aborigines by using census survey method in 1940's. Clinical cases of alcoholism were rare in clinical psychiatric service at that time. In 1980's, the epidemiological study using the Chinese Diagnostic Interview Schedule as case identification tool, revealed that the lifetime prevalence of alcohol abuse (AA) and alcohol dependence (AD) in Taiwan Chinese were 3.4%, 1.5%; 8.0%, 1.8% and 6.3%, 1.2% in the metropolitan city, small town and rural village respectively. By using the similar case identification tool, the Taiwan aborigines of Atayal, Paiwan and Yamei had respectively the lifetime prevalence of the AA and the AD of 11.6%, 11.4%; 14.2%, 9.0% and 8.1%, 6.4%. Nowadays, the presence of the clinical cases of alcoholism in the psychiatric inpatients are constant. The prevalence study of alcoholism in the non-psychiatric population of the general hospital also showed unnegligible case number of alcoholism. The facilities of the beer houses, bars are very popular in Taiwan. Drinking is a very popular entertainment and the people usually forced others to drink more in the social intercourse. The high tolearance of alcohol is also considered as a socially desirable trait which can be proud of in front of others. The mass media frequently reported the news of behavioral problems such as physical violence, accidents related to excessive drinking. All these data highly suggested that alcoholism does have increased prevalence in the present day society of Taiwan.