The Use of a Symptom Checklist (SCL-90-R) as an Easy Method to Estimate the Relapse Risk after Alcoholism Detoxification

Abstract

We tested the use of some subscales of the psychiatric symptom checklist SCL-90-R in predicting relapse within a 1-year follow-up period after a combined detoxification- and abstinence-focused day patient psychotherapy program in 20 men and 13 women with alcohol dependence. Scores of the SCL-90-R subscales interpersonal sensitivity (p = 0.008), anxiety (p = 0.022), phobic anxiety (p = 0.019) and Global Severity Index (GSI; p = 0.040) on admission were higher in the subgroup with relapse within the first year after therapy. A decrease in depression (p = 0.004), anxiety (p = 0.006) and GSI (p = 0.006) scores during therapy was associated with a longer abstinence duration (shorter vs. longer than 24 weeks). Therefore we propose to further investigate the capacity of the SCL-90-R to identify subgroups at higher risk for relapse after detoxification and abstinence therapy in patients with alcohol dependence.

Psychological Distress in Alcohol-Dependent Patients

“…The results of the presented study generally correspond with the fi ndings of Lucht et al [13] and Slater and Linn [17] who found that the GSI predicts the relapse risk. At the beginning of treatment, a high GSI score might indicate comorbid psychopathology or general psychological distress as a result of typical consequences of alcohol dependence, for example, divorce, unemployment, social withdrawal, etc.…”

“…In this study, the infl uence of alcohol withdrawal symptoms on the GSI is supposed to be low, because the SCL-90-R was administered 3 weeks after admission. Compared to the GSI scores in the study of Lucht et al [13] , the psychological distress at admission in this study is obviously lower which can also be attributed to the differences in time of assessment. In contrast to the fi ndings of Lucht et al [13], psychological distress of later abstinent vs. alcohol consuming patients does not differ signifi cantly at the beginning but at the end of treatment and at follow-up.…”

“…Compared to the GSI scores in the study of Lucht et al [13] , the psychological distress at admission in this study is obviously lower which can also be attributed to the differences in time of assessment. In contrast to the fi ndings of Lucht et al [13], psychological distress of later abstinent vs. alcohol consuming patients does not differ signifi cantly at the beginning but at the end of treatment and at follow-up. Yet, it is not clear what causes the described difference in empirical fi ndings; further research should try to clarify this point.…”

“…This is especially Based on the cited background and the results of Lucht et al [13], the following hypotheses were formulated:…”

“…In three studies, the SCL-90-R proved to be an adequate screening instrument for comorbid psychopathology in alcohol-dependent patients [10][11][12] . The effect of comorbid psychopathology measured with the SCL-90-R on long-term therapy outcome was evaluated in a study by Lucht et al [13] . In that study, the SCL-90-R is employed in a pre-post design at the beginning and the end of treatment.…”