Efficacy of an Intensive Outpatient Rehabilitation Program in Alcoholism: Predictors of Outcome 6 Months after Treatment

Abstract

Treatment of alcohol-dependent patients was primarily focused on inpatient settings in the past decades. The efficacy of these treatment programs has been evaluated in several studies and proven to be sufficient. However, with regard to the increasing costs in public healthcare systems, questions about alternative treatment strategies have been raised. Meanwhile, there is growing evidence that outpatient treatment might be comparably effective as inpatient treatment, at least for subgroups of alcohol dependents. On that background, the present study aimed to evaluate the efficacy of a high-structured outpatient treatment program in 103 alcohol-dependent patients. 74 patients (72%) terminated the outpatient treatment regularly. At 6 months’ follow-up, 95% patients were successfully located and personally re-interviewed. Analyses revealed that 65 patients (64%) were abstinent at the 6-month follow-up evaluation and 37 patients (36%) were judged to be non-abstinent. Pre-treatment variables which were found to have a negative impact (non-abstinence) on the 6-month outcome after treatment were a higher severity of alcohol dependence measured by a longer duration of alcohol dependence, a higher number of prior treatments and a stronger alcohol craving (measured by the Obsessive Compulsive Drinking Scale).Further patients with a higher degree of psychopathology measured by the Beck Depression Inventory (depression) and State-Trait Anxiety Inventory (anxiety) relapsed more often. In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program.

Predictors of Posttreatment Drinking Outcomes in Patients with Alcohol Dependence

“…Better outcomes, understood as lower relapse and greater abstinence rates, have been predicted by: being employed [3], having family support [4,5,9,10], female gender [3], older age [3], and more years of schooling [11]. …”

“…Better outcomes have been predicted by: more participation in treatment or a longer duration of care [10,11,17], use of medications like naltrexone or psychotherapy like cognitive behavioral interventions [18], better social adjustment [17], and more reliance on approach coping and less reliance on avoidance coping [16,17]. …”

Metabolite Levels in the Brain Reward Pathway Discriminate Those Who Remain Abstinent From Those Who Resume Hazardous Alcohol Consumption After Treatment for Alcohol Dependence

“…A LCOHOL-USE DISORDERS (AUDs; i.e., alcohol dependence and abuse) are characterized by a chronically relapsing/remitting course over the lifetime (Dawson et al, 2007;Jin et al, 1998;Miller et al, 2001;Zywiak et al, 2006). The resumption of hazardous levels of alcohol consumption after treatment is common (Donovan, 1996;Maisto and Connors, 2006;Miller et al, 2001;Monahan and Finney, 1996), and appears to be mediated by a complex interplay among genetic, neurobiological, neurocognitive, psychological/psychiatric, and sociodemographic factors (Adinoff et al, 2005;Baler and Volkow, 2006;Bottlender and Soyka, 2005;Bradizza et al, 2006;Glenn and Parsons, 1991;Goodman, 2008;Heinz et al, 2003;Jin et al, 1998;Koob, 2003;Moos and Moos, 2006;Parsons et al, 1990;Sher et al, 2005;Weiss and Porrino, 2002;Zywiak et al, 2006). A considerable amount of research has investigated the psychological, psychiatric, sociodemographic, and behavioral correlates of relapse following treatment; however, the neurobiological mechanisms underlying relapse in humans have only recently begun to be delineated, largely because of advances in invivo magnetic resonance and positron emission tomography neuroimaging methods (Volkow et al, 2004).…”

German Medical Students’ Beliefs about How Best to Treat Alcohol Use Disorder

“…It is one of the most frequent psychiatric disorders and causes enormous societal costs [1,2,3,4,5]. Treatment options for AUD include self-help groups [6], support provided by general practitioners [7], and inpatient [8] and outpatient interventions [9] including rehabilitation [5,10,11]. Other interventions (e.g.…”