The pattern of cognitive deficits and their time-dependent recovery were investigated in a cohort of 49 male alcohol-dependent patients using a repeated measurement design with 49 healthy male controls matched for age, education, and marital status. We combined parts of the Halstead Reitan Battery and the Wechsler Memory Scale with tests that are widely used in German-speaking countries. Patients were tested in the first week (T1) and 5 weeks later (T2) at the end of the in-patient treatment programme. Matched controls were tested also at T1 and T2, which enabled us to take learning effects into account. At T1, the patients showed distinct cognitive deficits on 5 of 12 neuropsychological parameters (perceptual-motor speed, verbal short-term memory, verbal knowledge, non-verbal reasoning, spatial imagination). At T2, significant improvements had occurred in four of the five dysfunctional domains with a significant difference remaining in verbal short-term memory. Duration of dependency and length of abstinence prior to testing had no essential effects on neuropsychological functions. Our results provide evidence for the well-established fact that chronic alcoholism has detrimental effects on cognitive performance, but that performance improves with neuropsychological recovery which occurs rapidly within weeks when abstinence is maintained. Cognitive deficits seem to be similar across different studies and cultures.

We tested the hypothesis that alcoholics develop a disease-related attentional bias. Therefore, alcohol-related, but task-irrelevant, words should cause a specific perceptual-processing bias. We investigated this by using a special color-naming task. We subjected 40 male alcohol-dependent inpatients and 40 healthy male controls (matched according to age and verbal IQ) to a modified card version of the Stroop color-naming task that consisted of a neutral and an alcohol word condition ("Alcohol Stroop"). Alcoholic inpatients performed significantly poorer than the control group under the critical experimental condition (color-naming of disease-related words), as compared with the noncritical condition (color-naming of neutral words; p = 0.03). Concerning the possible neuropsychological impairment of the patients, no effects could be found on the reaction time of the "Standard Stroop" using only neutral words (i.e., color-naming of incongruent color words administered without time limitation). The information processing bias on the "Alcohol Stroop" thus qualifies as a cognitive process, which is independent from putative neuropsychological deficits of alcoholic patients and might represent an essential feature of alcoholic psychopathology. The "Alcohol Stroop" contributes to the experimental psychopathology of alcoholism.

Autogenic training (AT) is a self-relaxation procedure by which a psychophysiological determined relaxation response is elicited. A meta-analysis was performed to evaluate the clinical effectiveness of AT. Seventy-three controlled outcome studies were found (published 1952-99). Sixty studies (35 randomized controlled trials [RCT]) qualified for inclusion in the meta-analysis. Medium-to-large effect sizes (ES) occurred for pre-post comparisons of disease-specific AT-effects, with the RCTs showing larger ES. When AT was compared to real control conditions, medium ES were found. Comparisons of AT versus other psychological treatment mostly resulted in no effects or small negative ES. This pattern of results was stable at follow-up. Unspecific AT-effects (i.e., effects on mood, cognitive performance, quality of life, and physiological variables) tended to be even larger than main effects. Separate meta-analyses for different disorders revealed a significant reduction of the heterogeneity of ES. Positive effects (medium range) of AT and of AT versus control in the meta-analysis of at least 3 studies were found for tension headache/migraine, mild-to-moderate essential hypertension, coronary heart disease, asthma bronchiale, somatoform pain disorder (unspecified type), Raynaud's disease, anxiety disorders, mild-to-moderate depression/dysthymia, and functional sleep disorders.

Ziel: Ziel ist die Erstellung einer S2-Leitlinie (nach AMWF 2001) für die Postakutbehandlung alkoholbezogener Störungen. </p><p> Methode: Systematische Literaturrecherche, Expertenbewertung und Konsensuskonferenzen. </p><p> Ergebnis: Postakute Behandlungen bestehen in Maßnahmen zur Entwöhnung von Alkohol, d. h. zum Erhalt, der Verbesserung oder der Wiederherstellung der Funktions- und Leistungsfähigkeit des chronisch Alkoholkranken in Alltag und Beruf. Suchtspezifische Maßnahmen und allgemeine Methoden (z. B. Psychotherapie, Ergo-/Arbeitstherapie) werden nach Evidenzklassen (nach SIGN 1999) und Empfehlungsstärken (nach APA 1995) bewertet dargestellt und im Rahmen integrierter Programme als Sequenzbehandlungen empfohlen. </p><p>Schlussfolgerung: Diese evidenzbasierte Leitlinie kann dem praktisch Tätigen in Klinik und Praxis im medizinischen, psycho- und soziotherapeutischen Bereich als Orientierung dienen und dazu beitragen, die Langzeitbehandlung der Alkoholabhängigen auf eine allgemeine empirische Grundlage zu stellen.

Diese Behandlungsleitlinie wurde seit dem Jahre 2000 unter der Federführung der DG-Sucht und der DGPPN von Experten aus insgesamt 17 Fachgesellschaften und Organisationen im Rahmen eines mehrjährigen, interdisziplinären Konsentierungsprozesses erarbeitet. Damit liegt nun gemäß der AWMF-Klassifikation eine S2-Leitlinie für Diagnostik und Behandlung der ICD-10: F.10 »Psy-chische und Verhaltensstörungen durch Alkohol« mit überwiegender Evidenzbasierung vor; die dem Arzt als Entscheidungshilfe, nicht als Behandlungsvorgabe dienen soll.