Efficacy of an intensive outpatient rehabilitation program in alcoholism: predictors of outcome 6 months after treatment.
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.
Department of Psychiatry, Ludwig Maximilians University, Munich, Germany. bottlend@psy.med.uni-muenchen.de
Miriam
M
Bottlender
Michael
M
Soyka
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D000553:Ambulatory Care; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003422:Critical Care; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D016896:Treatment Outcome