Treatment Outcome in Alcoholism – A Comparison of Self-Report and the Biological Markers Carbohydrate-Deficient Transferrin and γ-Glutamyl Transferase

Abstract

The primary source for evaluating treatment outcome in alcoholism is usually verbal self-report. Because the validity of self-report is often doubted, more objective markers for treatment outcome are needed. In this study, we compared self-report data from 238 male alcohol-dependent patients participating in a combined 6-week inpatient followed by a 1-year outpatient treatment program with the biological markers carbohydrate-deficient transferrin (CDT) and γ-glutamyl transferase (GGT). According to self-report, over 70% of the patients had a positive treatment outcome (57% abstinence, 16% intermediate relapse). These results are supported by the general reduction of CDT and GGT during the treatment period (p < 0.001). When we performed a cross-sectional analysis at 6 months during the outpatient program, there was a high consistency of self-report data with the biological markers (CDT 93%, GGT 91%, CDT/GGT 85%). Our results support the hypothesis that in abstinence- oriented treatment programs, self-reports are valid and can be used as the basis of measurement for treatment outcome.

Appetitive effects of drug cues modelled by pictures of the intake ritual: generality of cue-modulated startle examined with inpatient alcoholics

“…Testing of the data using a Friedman two-way analysis of variance also failed to indicate any significant effects (chi square values <1.5). From the fact that social drinkers and smokers did report significant craving in response to the present or analogous protocols (Mucha et al 1999), we see these data on desire for alcohol as further underscoring possible specific problems that alcoholics have in reporting information on alcohol (see Mundle et al 1999a).…”

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents

“…All patients were personally interviewed and all patients were well known by the interviewer (S.Y.). Several studies have shown a high validity and high reliability of self-report data of alcoholdependent patients in treatment compared to toxicologic analyses of blood or collateral informant reports (73,74). Other important limitation of the present study was that no scale were used to evaluate severity of anxiety and depressive symptoms, since they may be related with not only relapse (12,75,76), but also with HSM, HSA and defense styles.…”

Prospektive Untersuchung zur Effizienz der ambulanten Entwöhnungstherapie bei alkoholabhängigen Patienten

“…Diese Befunde sind vergleichbar mit Ergebnissen anderer Studien zur Effizienz ambulanter wie stationärer Entwöh-nungstherapien. Es wurden Abstinenzquoten von ambulanten Therapien zum 6-Monats-Follow-up berichtet zwischen 34%-59% [4,23,24] und 48% zum 18-bis 24-Monats-Follow-up [35]. Studien mit vergleichbarer Katamnesedauer ergaben Abstinenzquoten zwischen 40-60% für stationäre Therapien [17].…”

“…In einer kürzlich erschienenen Metaanalyse zur Frage der Therapieerfolge bei alkohol-und drogenabhängi-gen Patienten [31] konnten nur 3 Studien zu dieser Frage präsentiert werden, darunter die von uns früher durchgeführte Katamnese [23,35,38].Die Abstinenzquoten bewegten sich dabei bei einem Ausschöpfungsgrad von 66-78% zwischen 37% und 48% und waren damit durchaus vergleichbar mit den Ergebnissen stationärer Entwöhnungstherapien. Für den Bereich der teilstationären Entwöh-nungstherapie gibt es einige Erfahrungsberichte und Katamnesestudien von Tageskliniken aus der ehemaligen DDR.…”