title: Determinants of improvement in quality of life of alcohol-dependent patients during an inpatient withdrawal programme.
abstract: BACKGROUND
  To investigate the improvement in quality of life (QoL) of alcohol-dependent patients during a 3-week inpatient withdrawal programme, and to identify the sociodemographic, clinical and alcohol-related variables associated with baseline QoL on admission and with improvement of QoL during residential treatment.
  
  
  METHODS
  This prospective, observational study included 414 alcohol-dependent patients, hospitalised for a period of 3 weeks. QoL was measured on admission and at discharge using the French version of the Medical Outcome Study SF-36. The mean scores for each dimension and for the Physical and Mental Component Summary scores were calculated.
  
  
  RESULTS
  The mean scores per dimension and the mean Physical and Mental Component Summary scores were significantly lower on admission than at discharge; the lowest scores being observed for social functioning and role limitations due to emotional problems. At discharge, the mean scores per dimension were similar to those observed in the French general population. Female gender, age > 45 years, living alone, working as a labourer or employee, somatic comorbidity, and the existence of at least five criteria for alcohol dependence according to the DSM-IV classification were associated with a low Physical Component Summary score on admission; psychiatric comorbidity, the presence of at least five DSM-IV dependence criteria, smoking and suicidality were associated with a low Mental Component Summary score on admission. The increase in Physical and Mental Component Summary scores during hospitalisation was more marked when the initial scores were low. Apart from the initial score, the greatest improvement in Physical Component Summary score was seen in patients with a high alcohol intake and in those without a somatic comorbidity; the increase in Mental Component Summary score was greatest in patients without psychotic symptoms and in those who abused or were dependent on illegal drugs.
  
  
  CONCLUSIONS
  QoL improvement after a residential treatment was related to low QoL scores at admission. Improvement in physical component of QoL was related to baseline alcohol intake and good somatic status. Improvement in mental component of QoL was related to other drugs abuse/dependence.
authors.affiliation: Centre de Traitement des Addictions, Hôpital Emile Roux, Assistance Publique-Hôpitaux de Paris, 94450 Limeil-Brévannes, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lahmek
authors.forename: Ivan
authors.initials: I
authors.lastname: Berlin
authors.forename: Laurent
authors.initials: L
authors.lastname: Michel
authors.forename: Chafia
authors.initials: C
authors.lastname: Berghout
authors.forename: Nadine
authors.initials: N
authors.lastname: Meunier
authors.forename: Henri-Jean
authors.initials: HJ
authors.lastname: Aubin
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy*; D004522:Educational Status; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D010297:Paris; D011446:Prospective Studies; D011788:Quality of Life; D012114:Residential Treatment / Q000379:methods; D012923:Social Class; D013997:Time Factors