title: Predictors of dropout in an outpatient treatment for problem drinkers including cognitive-behavioral therapy and the opioid antagonist naltrexone.
abstract: OBJECTIVE
  This study investigated predictors of dropout in an outpatient treatment program for problem drinking that included individual cognitive-behavioral therapy combined with naltrexone. Specifically, we investigated whether sociodemographic factors, severity of alcohol dependence, history of problem drinking, or intensity of alcohol craving assessed at the beginning of the treatment predicted dropout from an outpatient program among a sample of 372 patients (65% male). We also investigated whether the effectiveness of the treatment (the change in alcohol consumption and symptoms of alcohol craving) or adherence to naltrexone was related to dropout.
  
  
  METHODS
  Predictors of dropout were investigated using an analysis of covariance with the number of attended treatment sessions as an independent variable.
  
  
  RESULTS
  Our results demonstrated that the treatment entry factors predictive of dropout were younger age, lower severity of alcohol dependence, better ability to resist and control alcohol use, and lower obsession with alcohol. In addition, those who dropped out were more likely to begin the program by abstaining from alcohol and had lower adherence to naltrexone use than those who completed the program. The length of stay for treatment was not related to change in alcohol consumption.
  
  
  CONCLUSIONS
  Patients with less severe alcohol-related problems may lack motivation for treatment, specifically cognitive-behavioral therapy and naltrexone. These patients may benefit more from less intensive treatments.
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Finland, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Salla
authors.initials: S
authors.lastname: Vuoristo-Myllys
authors.forename: Jari
authors.initials: J
authors.lastname: Lahti
authors.forename: Hannu
authors.initials: H
authors.lastname: Alho
authors.forename: Juhani
authors.initials: J
authors.lastname: Julkunen
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000379:methods; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009042:Motivation; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D010045:Outpatients; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone