title: Predictive factors for relapse after an integrated inpatient treatment programme for unipolar depressed and bipolar alcoholics.
abstract: OBJECTIVE
  The aim of this study was to examine prospectively examined predictors of relapse in alcohol dependence with comorbid affective disorder.
  
  
  METHODS
  One hundred and eighty-three unipolar depressed or bipolar alcoholics who completed an integrated inpatient treatment programme for dual diagnosis were assessed at baseline, post-treatment discharge and at 3 and 6 months post treatment. Backwards stepwise likelihood ratio multiple logistic regression was used to investigate the impact of multiple covariates on relapse to alcohol in the 0-3- and 3-6-month period post discharge.
  
  
  RESULTS
  The retention rate at 3 months post discharge was 95.3% (177 patients) and at 6 months it was 87.4% (162 patients). Higher level of anxiety at baseline and discharge was significantly associated with relapse at 3, but not at 6 months, in all subjects. Higher baseline alcohol use disorder identification test scores were associated with relapse at 3 and at 6 months. Intention and planning to attend aftercare after discharge from the hospital were associated with non-relapse at 3 and 6 months, respectively. Levels of depression, of elation and of craving at baseline were not significantly predictive of relapse. Those who had relapsed at 3 months were significantly more likely to remain drinking at 6 months. Rehospitalization within the first 3 months post discharge appeared to be protective against further relapse.
  
  
  CONCLUSIONS
  Baseline patient factors, including levels of anxiety, appear to play a significant role in relapse to alcohol in this difficult to treat population.
authors.affiliation: Department of Psychiatry, St. Patrick’s Hospital and Trinity College Dublin, James Street, Dublin 8, Ireland. cfarren@stpatsmail.com
authors.forename: Conor K
authors.initials: CK
authors.lastname: Farren
authors.forename: Sharon
authors.initials: S
authors.lastname: McElroy
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000517:prevention & control* / Q000523:psychology*; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055502:Secondary Prevention; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome