title: Gender differences in the efficacy of brief interventions with a stepped care approach in general practice patients with alcohol-related disorders.
abstract: OBJECTIVE
  To analyse gender differences in the efficacy of stepped care brief interventions for general practice patients with alcohol problems.
  
  
  METHODS
  Data are part of "Stepped Interventions for Problem Drinkers," in which 10,803 patients from 85 general practitioners were screened using alcohol related questionnaires; 408 patients were randomized (32% were female) to a control (booklet only) or two different intervention groups: stepped care (feedback, manual, and up to three counselling sessions depending on the success of the previous intervention) and fixed care (four sessions). Response rate for the 12 months follow-up was 91.7%.
  
  
  RESULTS
  Regression analysis revealed a significant effect size only in women (P = 0.039). After excluding alcohol dependents and binge drinkers, an effect size (R(2)) of 0.031 (P = 0.050) in women and an effect size (R(2)) of 0.069 (P = 0.057) in men was obtained. Among the patients in stepped care who, by the first assessment point, had reduced drinking to within safe-drinking limits, there was a tendency for females to have achieved this more often than males (40% vs. 24%; P = 0.089).
  
  
  CONCLUSIONS
  In a heterogeneous sample, the intervention was only effective for women. Women tended to profit more from the first, less intensive intervention than men. When analysis was limited to those reporting "at risk" average daily consumption and "alcohol abuse," the gender differences in efficacy appeared to be less, but the study was not sufficiently powered to affirm that.
authors.affiliation: Dept. of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Susa
authors.initials: S
authors.lastname: Reinhardt
authors.forename: Gallus
authors.initials: G
authors.lastname: Bischof
authors.forename: Janina
authors.initials: J
authors.lastname: Grothues
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.forename: Hans-jürgen
authors.initials: HJ
authors.lastname: Rumpf
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005194:Family Practice / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011614:Psychotherapy, Brief / Q000379:methods; D012737:Sex Factors