Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder

Suter, Marius; Strik, Werner; Moggi, Franz

doi:10.1016/j.jsat.2011.03.005

Cited by 49 publications

(42 citation statements)

References 14 publications

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“…transient) as well as proximal and distal variables related to treatment outcome (see above limitations) that were not obtained in this study (Witkiewitz and Marlatt, 2007). Overall, the findings suggest effective treatment of mood disorder and cigarette smoking in conjunction with AUD-focused interventions may promote better long-term treatment outcomes (Cavazos-Rehg et al, 2014, Suter et al, 2011, McKee and Weinberger, 2013, Pettinati et al, 2013, Hobbs et al, 2011) and assist in breaking the relapse-remit cycle that afflicts so many individuals with AUD. Larger scale studies are necessary to determine the relative associations of hypertension, hepatitis C and hyperlipidemia with AUD treatment outcome.…”

Section: Discussionmentioning

confidence: 93%

“…The BDI reflects the magnitude of depressive symptomatology over 1 week, which can be strongly influenced by recent life events and environmental circumstances (Richter et al, 1998), including substance abuse treatment. In multiple studies, a diagnosis of a unipolar mood disorder was associated with relapse in AUD treatment [see (Durazzo et al, 2008, Hobbs et al, 2011, Suter et al, 2011, Greenfield et al, 1998, Rounsaville et al, 1987)], while level of self-reported depressive symptomatology was not related to relapse in others (Soyka and Schmidt, 2009, Durazzo et al, 2008, Bradizza et al, 2006, Greenfield et al, 1998). Comorbid recurrent MDD may be associated with greater probability of relapse for a number of reasons: Individuals with AUD and comorbid MDD demonstrate greater maladaptive coping skills, dysfunctional emotional regulation, and abnormal functioning of the hypothalamic-pituitary-adrenal cortex axis (Kahler et al, 2002, Compare et al, 2014, Moses and Barlow, 2006), which are associated with increased risk of relapse (Moos and Moos, 2007, Seo and Sinha, 2014, Berking et al, 2011); those with AUD and comorbid MDD may resume alcohol consumption to ameliorate the core symptoms of recurrent MDD (Hesselbrock et al, 1986, Pettinati et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…While magnetic resonance neuroimaging modalities (e.g., structural, perfusion, diffusion tensor imaging, resting and task-based BOLD) can provide valuable information on neurobiological correlates of relapse, co-occurring psychiatric conditions (e.g., mood disorders, other substance use disorders) in those seeking treatment for AUD are also robustly associated with increased risk for relapse after treatment (Durazzo et al, 2008, Meyerhoff et al, 2013, Seo and Sinha, 2014, Hobbs et al, 2011). Unipolar depressive disorders and chronic smoking are among the most prevalent co-occurring conditions in those with AUD (Durazzo and Meyerhoff, 2007, Moss et al, 2015, Grant et al, 2015), and individuals with a history of co-occurring AUD and depressive disorders show markedly greater risk of relapse following treatment [see (Durazzo et al, 2008, Hobbs et al, 2011, Suter et al, 2011) and references therein]. Additionally, those with remitted AUD, who are cigarette smokers, demonstrate significantly increased relapse risk (Satre et al, 2007, Weinberger et al, 2015), and smoking cessation is associated with decreased risk of meeting diagnostic criteria for an AUD in those with a history of AUD (Cavazos-Rehg et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder

Durazzo

Meyerhoff

2016

Alcoholism Clin & Exp Res

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Background Relapse in alcohol use disorders (AUD) is related to a complex interplay among multiple biological, psychiatric, psychological and psychosocial factors, which may change dynamically during and after treatment. At treatment entry for AUD, morphological abnormalities in anterior frontal regions and the insula have been observed in those who ultimately relapse following treatment. The goal of this study was to determine if measures anterior frontal and insula measures of regional brain thickness, surface area and volume predict post-treatment drinking status (i.e., relapser or abstainer) over an extended period after outpatient treatment for AUD, while concurrently considering common psychiatric, psychological and psychosocial factors previously associated with relapse. Methods Alcohol dependent individuals (n = 129) were followed for 18 months after treatment to determine post-treatment drinking status [Abstainers (n = 47) or Relapsers (n = 82)]. Brain morphometrics were derived from FreeSurfer. Receiver operator characteristic (ROC) curve analysis was used to identify the regional brain thickness, surface area and volume (all scaled to intracranial volume), demographic, psychiatric, other substance use (e.g., cigarette smoking) and alcohol consumption variables, obtained at entry into treatment, that best predicted post-treatment drinking status. Survival analyses determined variables that were related to duration of abstinence after treatment. Results ROC analyses indicated that mood disorders, education, and volumes of the right caudal ACC, right rostral ACC and total right frontal gray matter were significant predictors of post-treatment drinking status. Among Relapsers, survival analyses showed smokers and individuals with a comorbid medical condition relapsed earlier after treatment. Additionally, a greater frequency of smokers relapsed within 6 months of treatment. Conclusions Results reinforce that relapse in AUD is a function of multiple biological, psychiatric, psychological and psychosocial factors. Effective treatment of depressive disorders and cigarette smoking concurrent with AUD-focused interventions may promote better treatment outcomes.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder

Durazzo

Meyerhoff

2016

Alcoholism Clin & Exp Res

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“…Of these, 587 patients had AUD only, 415 patients completed the study inventories at admission, at discharge, and at the 1-year follow-up. We excluded patients who consumed alcohol during residential treatment, a variable associated with lower abstinence rates at follow-up (15) and to make sure that patients' decision for one of the three drinking goals is not affected by current alcohol use. The final sample included 289 abstinent patients during treatment.…”

Section: Patientsmentioning

confidence: 99%

Association Between Drinking Goal and Alcohol Use One Year After Residential Treatment: A Multicenter Study

Meyer

Wapp

Strik

et al. 2014

Journal of Addictive Diseases

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This study examined whether patients' drinking goals at admission to and discharge from 12 residential alcohol use disorder treatment programmes were associated with alcohol-related outcomes at 1-year follow-up. Detoxified patients (N=289) completed assessments at admission, after treatment, and at 1-year follow-up. Drinking goals of abstinence, conditional abstinence (in principle abstinence but potential occurrence of lapses or drinking, when urges are strong), and controlled drinking changed during treatment and predicted the 1-year follow-up outcomes (abstinence, number of standard drinks, and number of days to the first alcohol use). Goals at discharge had a better predictive value. The goal of abstinence at discharge had better outcomes than conditional abstinence; the poorest had controlled drinking.Drinking goal and alcohol use outcome 3

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“…Comorbidity with psychiatric problems is associated with a poorer prognosis of both conditions due to diagnostic problems and difficulties with the care pathway [13–15]. …”

Section: Introductionmentioning

confidence: 99%

A prospective hospital study of alcohol use disorders, comorbid psychiatric conditions and withdrawal prognosis

et al. 2016

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BackgroundThe objective of this study was to describe the profile and alcoholic status of a population with alcohol use disorders (AUD) requesting help from a psychiatric hospital to stop drinking, as well as their clinical outcome and care consumption over the 2 years following the request.MethodsThe visits were conducted at baseline (M0) and at 6, 12, 18 and 24 months (M6, M12, M18, M24). Demographic, clinical and psychometric data [Beck Depression Inventory (BDI), AUDIT questionnaire, Global Assessment of Functioning (GAF) scale], and information regarding the use of psychiatric care and therapeutics were collected.ResultsThe 330 subjects included were mostly male, aged 45.2 ± 10.2 years with an employment rate of 55.4 %, living alone (69.1 %), with a psychiatric comorbidity (60.9 %), especially depressive, and with few somatic complications. Their global functioning was poor (GAF score 49.14 ± 15.6), and less than 10 % were addicted to another substance. The abstinence rate at 24 months was 41.4 %, but only 23 % (20) abstained continuously between M0 and M24, and 66.7 % (58) intermittently. The likelihood of abstinence at M24 was greater for females aged over 60 years. The BDI score decreased significantly between M0 and M24. In all, 56.2 % of the participants were re-hospitalized after weaning, but were not integrated in long-term medical care.ConclusionsAbstinence after alcohol withdrawal fluctuated over time indicating the need for long-term support. The treatment of AUD should not target total, continuous abstinence. Prognostic profiles combining socio-demographic, clinical and biological indicators must be established.

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Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder

Cited by 49 publications

References 14 publications

Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder

Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder

Association Between Drinking Goal and Alcohol Use One Year After Residential Treatment: A Multicenter Study

A prospective hospital study of alcohol use disorders, comorbid psychiatric conditions and withdrawal prognosis

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