title: [Sociomedical outcome after outpatient withdrawal treatment: Results of a model project of integrated care].
abstract: BACKGROUND
  Dependence disorders represent a large socioeconomic problem due to insufficient and delayed diagnostics and treatment. This study investigated the effectiveness of the integrated care concept involving rapid clarification, diagnosis, initiation of withdrawal treatment, transfer to addiction rehabilitation and abstinence.
  
  
  METHODS
  In this prospective observational study 293 patients with dependency disorders were investigated in an outpatient withdrawal treatment concept with respect to the course of the integrated care concept, sociodemographic data and other important variables of addiction. In a 2-year follow-up period abstinence (after t1 = 3, t2 = 12 and t3 = 24 months), referral to and beginning addiction rehabilitation were recorded.
  
  
  RESULTS
  All patients completed the outpatient detoxification treatment concept without complications of whom 95.3% were abstinent and 52.9% could be placed in long-term treatment (duration 1 year). The 24-month abstinence (DGSS 4) was high but decreased significantly over time (t1 = 59.4%, t2 = 50.5%, t3 = 39.7%, p<0.001). Placement in a long-term rehabilitation program showed the greatest effect on abstinence (p<0.001), followed by treatment duration (p<0.001). The disease severity (stress index) showed significantly lower negative effects (p<0.01).
  
  
  CONCLUSIONS
  The integrated care concept is an effective outpatient withdrawal treatment, despite the methodological limitations. Break points in the addiction help system are stabilized and patients can be successfully treated. The results are equivalent to a qualified inpatient withdrawal treatment taking the recommendations of the Federal Medical Council into consideration.
authors.affiliation: Ianua Gesellschaft für Prävention und Sozialtherapie mbH, Lisdorfer Str. 2, 66740, Saarlouis, Deutschland. davidsteffen@ianua-gps.de.|Facharztpraxis Steffen, Psychiatrie und Psychotherapie, Saarlouis, Deutschland. davidsteffen@ianua-gps.de.
authors.forename: D V
authors.initials: DV
authors.lastname: Steffen
authors.affiliation: Ianua Gesellschaft für Prävention und Sozialtherapie mbH, Lisdorfer Str. 2, 66740, Saarlouis, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Steffen
authors.affiliation: Ianua Gesellschaft für Prävention und Sozialtherapie mbH, Lisdorfer Str. 2, 66740, Saarlouis, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Steffen
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D000067250:Psychiatric Rehabilitation / Q000458:organization & administration / Q000706:statistics & numerical data*; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Alcohol addiction; Ambulant withdrawal treatment; Dependence; Drug addiction; Psychotherapy